Stroke Prevention & Cerebrovascular Care · Neurosurgery

Carotid Artery Stenosis Treatment with Dr. Shah-Naz Khan, Neurosurgeon in Flint, MI

Carotid artery stenosis is a narrowing of the carotid arteries in the neck, the main vessels carrying blood to the brain. It is usually caused by plaque build-up and often has no symptoms, but it raises the risk of stroke. Treatment ranges from medication and lifestyle changes to carotid endarterectomy or minimally invasive carotid stenting.

Sudden face drooping, arm weakness, slurred speech, or vision loss? These are signs of a stroke. Call 911 right away, even if the symptoms go away. This page is not for emergencies.

What it is

Narrowing of a carotid artery in the neck, usually from plaque, reducing blood flow to the brain.

Who is at risk

More common with age, high blood pressure, high cholesterol, smoking, and diabetes.

Common symptoms

Often none. The first sign can be a warning stroke (TIA) or a stroke.

Emergency signs

Face drooping, arm weakness, speech trouble. Think F.A.S.T. and call 911.

Main treatments

Medication and risk-factor control, carotid endarterectomy, or carotid stenting.

Plain-language definition

What is carotid artery stenosis?

You have two carotid arteries, one on each side of your neck, that carry most of the blood supply to the brain. Carotid artery stenosis, also called carotid artery disease, is a narrowing of one of these arteries, usually caused by a build-up of fatty plaque called atherosclerosis.

The danger is not just the narrowing itself. Plaque can roughen the artery wall so that a small clot or a fragment of debris breaks off, travels to the brain, and blocks a vessel there. That is how carotid stenosis leads to a transient ischemic attack, a warning stroke, or a full stroke.

Because it involves the blood vessels that feed the brain, carotid disease sits directly within Dr. Khan's field of cerebrovascular and endovascular neurosurgery. The goal of treatment is to prevent a stroke before it happens. See cerebrovascular neurosurgery →

Why it matters

The narrowing
Plaque reduces blood flow through the carotid artery over time.
The real risk
Debris or a clot can break off and travel to the brain, causing a stroke.
The goal
Treatment aims to prevent a first or second stroke, often before any symptoms appear.
Warning signs

What are the warning signs of a stroke?

Carotid stenosis often has no symptoms until it causes a stroke or a warning stroke (TIA). The signs below are a true emergency, even if they last only a few minutes and then disappear.

Call 911 now if…

Think F.A.S.T. A transient ischemic attack (TIA) has the same signs and is a serious warning. Do not wait for symptoms to pass.

  • Face drooping or numbness on one side of the face
  • Arm or leg weakness or numbness, usually on one side of the body
  • Slurred speech, or trouble finding or understanding words
  • Sudden vision loss in one eye, severe dizziness, or a sudden severe headache

See a specialist soon if…

Not an emergency, but worth a cerebrovascular specialist's review to lower your stroke risk.

  • A scan or ultrasound found carotid narrowing and you want a clear prevention plan
  • A doctor heard a bruit, a whooshing sound, over an artery in your neck
  • You had a TIA in the past and want to reduce the risk of a future stroke
  • You have several risk factors and want your carotid arteries checked
Causes & risk factors

What causes carotid artery stenosis?

Carotid narrowing is driven by atherosclerosis, the same plaque process behind heart disease. Several risk factors can be lowered to slow it down.

Risk factors you may be able to change

  • High blood pressure, the leading contributor to artery damage
  • High cholesterol, which feeds plaque build-up
  • Smoking or tobacco use, a major and reversible risk
  • Diabetes, excess weight, and a lack of physical activity

Risk factors you cannot change

  • Older age, as arteries stiffen and gather plaque over time
  • A family history of atherosclerosis, stroke, or carotid disease
  • A personal history of coronary or peripheral artery disease
  • A prior stroke or transient ischemic attack (TIA)
Diagnosis

How is carotid artery stenosis diagnosed?

Carotid narrowing is measured with imaging of the neck arteries, often starting with a simple, painless ultrasound.

First & simplest

Carotid ultrasound

A painless Doppler ultrasound of the neck measures how fast blood is moving through the carotid artery, which shows how narrowed it is. It is often the first test.

Detailed maps

CTA or MRA

CT angiography or MR angiography produces detailed images of the carotid arteries from the neck up into the brain, helping confirm the degree of narrowing and plan treatment.

Most detailed

Cerebral angiogram

When the finest detail is needed, a catheter angiogram gives the clearest picture of the artery, and is sometimes combined with treatment such as stenting.

Treatment options

How is carotid artery stenosis treated?

Treatment depends on how narrowed the artery is and whether it has already caused symptoms. The goal in every case is to prevent a stroke.

Foundation of care

Medication & risk control

For milder or symptom-free narrowing, the mainstay is medical therapy: blood-pressure and cholesterol control, an antiplatelet such as aspirin, and quitting smoking. This alone can meaningfully lower stroke risk.

Open surgery

Carotid endarterectomy

Through a small incision in the neck, the surgeon opens the artery and removes the plaque. It is a long-established, effective way to reduce stroke risk for significant narrowing.

Minimally invasive

Carotid artery stenting

Through a catheter in a blood vessel, a stent is placed to hold the artery open, often with a filter to catch debris. It avoids a neck incision and can suit patients for whom open surgery is higher risk.

Always alongside

Lifestyle & follow-up

Whatever the approach, ongoing risk-factor control and follow-up imaging are central to keeping the artery, and the brain, protected over time.

How Dr. Khan decides

Choosing the right treatment for your arteries

The best option depends on how narrowed the artery is, whether it has already caused a TIA or stroke, the shape of the plaque, and your overall health. Significant narrowing that has caused symptoms is often treated with a procedure, while milder, symptom-free narrowing may be managed with medication and close monitoring.

Because Dr. Khan is trained in both open cerebrovascular surgery and minimally invasive endovascular techniques, she can weigh carotid endarterectomy against stenting based on what is safest for you, not a single tool. Every case is reviewed personally, and a procedure is recommended only when the benefit clearly outweighs the risk. See endovascular neurosurgery →

What shapes the plan

The narrowing
How severe it is, and whether it has already caused a TIA or stroke.
The plaque
Its shape and stability, and the anatomy of your neck arteries.
You
Your age, overall health, and the balance of risks for each option.
Recovery

Recovery and what to expect

Recovery depends on the treatment. Medical management involves no procedure, just ongoing medication, risk-factor control, and follow-up scans. Carotid stenting is minimally invasive and usually involves a short hospital stay, while carotid endarterectomy involves a small neck incision and a brief stay with a few weeks of healing.

Most people return to normal activities before long after either procedure, though your team will guide you on wound care, driving, and activity. Blood-pressure and cholesterol control continue for life, because they protect the treated artery and the rest of your blood vessels. These are general patterns, not a promise about any one person's recovery.

Follow-up ultrasound is a routine part of carotid care, so your surgeon can confirm the artery stays open over time.

General recovery patterns

Medical therapy
No procedure; ongoing medication, risk-factor control, and periodic ultrasound.
Carotid stenting
Minimally invasive, usually a short hospital stay and a quick return to activity.
Endarterectomy
A small neck incision, a brief stay, and a few weeks of healing.
For life
Blood-pressure and cholesterol control protect the artery long-term.
Why choose Dr. Khan

Stroke prevention from a fellowship-trained cerebrovascular neurosurgeon

Shah-Naz Khan, MD, FRCSC, FAANS is a fellowship-trained neurosurgeon who completed subspecialty training in cerebrovascular and endovascular neurosurgery at the Mayfield Clinic, University of Cincinnati. Carotid disease and stroke prevention are a core part of her practice, in the blood vessels that supply the brain.

She founded the Institute of General and Endovascular Neurosurgery in Flint, Michigan in 2014 on a simple standard: excellence, ethics, and integrity. Every case is personally evaluated by Dr. Khan, a procedure is recommended only when the benefit clearly outweighs the risk, and second opinions are genuinely welcomed. Explore cerebrovascular neurosurgery →

Why patients choose IGEN

  • Board-certified, fellowship-trained neurosurgeon
  • Trained in both carotid endarterectomy and minimally invasive stenting
  • Every case personally reviewed by Dr. Khan, not delegated
  • A procedure advised only when the benefit clearly outweighs the risk
  • Second opinions welcomed
Common questions

Carotid artery stenosis: frequently asked questions

What is carotid artery stenosis?
Carotid artery stenosis is a narrowing of one of the carotid arteries in the neck that carry blood to the brain, usually caused by a build-up of fatty plaque. It often has no symptoms but raises the risk of stroke, because plaque or a clot can break off and travel to the brain.
What are the symptoms of carotid artery stenosis?
It often has no symptoms until it causes a warning stroke (TIA) or a stroke. Warning signs include sudden face drooping, arm weakness, slurred speech, or vision loss in one eye. These are an emergency, so call 911 immediately, even if they pass quickly.
Is carotid artery stenosis serious?
It can be, because it is a major cause of stroke. The good news is that it is treatable and often preventable. Controlling blood pressure and cholesterol, not smoking, and, when needed, a procedure to clear or open the artery can significantly lower stroke risk.
Carotid endarterectomy vs. stenting: which is better?
Neither is best for everyone. Endarterectomy is an open surgery that removes the plaque and is long-established, while stenting is minimally invasive and can suit patients for whom surgery is higher risk. The right choice depends on the narrowing, the plaque, and your health. Dr. Khan is trained in both.
Do I need surgery for carotid artery stenosis?
Not always. Milder, symptom-free narrowing is often managed with medication and risk-factor control. A procedure is usually considered when the narrowing is significant or has already caused a TIA or stroke. A specialist can weigh your specific risk.
Can carotid artery stenosis be reversed?
Plaque build-up generally is not reversed, but its progression can be slowed and stroke risk lowered with blood-pressure and cholesterol control, not smoking, and medication. When narrowing is severe, a procedure can remove or bypass the blockage to protect the brain.
Do I need a referral to see Dr. Khan about carotid artery disease?
Requirements vary by insurer and situation. Many patients can request an appointment directly. If you have a referral it helps with coordination, but it is not always required. If you are unsure, contact the office and the team will advise the best next step.

Concerned about carotid disease or stroke risk? Get a plan.

Whether an ultrasound found carotid narrowing, you have had a TIA, or you simply want to lower your stroke risk, Dr. Khan will review your case personally and walk you through prevention and treatment options.

  • Request a consultation by phone or through the contact form.
  • Share any ultrasound, CT, or MRI results you already have so nothing is repeated needlessly.
  • Meet Dr. Khan for a personal review, a clear explanation, and honest next steps.
Medical disclaimer: This page is for general education and is not medical advice, a diagnosis, or a substitute for care from a qualified professional. It does not create a doctor-patient relationship. If you think you may be having a medical emergency, call 911 immediately. Always talk with your own physician about your specific situation.