Ask your primary care doctor to recommend a vascular surgeon for consultation. Generally, blood flow to the brain occurs through four main arteries through the neck; the 2 larger are the internal carotid arteries (the one referenced in your question) and 2 smaller are the vertebral arteries buried next to your spine in the middle of your neck.

The blood flow through these is shared by a circular structure near the base of the brain. Interruption of flow through one of the carotids diminishes the total flow. There is a large safety margin in blood flow through these combined channels.

Over time, accelerated by factors of heredity, life style, etc. the arteries narrow, not always symmetrically, and ultimately blood flow to the brain is threatened. Surgical removal of many types of increasing obstruction is possible, and generally safe. The flow through any given artery does not fall off dramatically until obstruction reaches more than 80%. Because narrowing occurs in ALL arteries, at some point inadequate brain blood flow becomes critically threatened.

Many vascular surgeons consider the risk of stroke to become great enough to justify surgical removal in any one carotid artery for obstruction of 80-85%. An important related factor is the morphology (exact location, structure, shape, symmetry) of the particular obstructing material which has a significant bearing on the risk of stroke. Also, the present or absence of warning symptoms or physical findings on medical examination are very relevant.

A judgment about the appropriateness and timing of possible surgical intervention is based on many factors, including the above, and is best determined by an experienced vascular surgeon in consultation with your primary physician.

These comments are general in nature and shouldn't be taken as specific medical advice to you, but may be helpful in your search for good medical care.

It is important to monitor your medical condition at this point no matter what the specific decision made at this time. Best wishes in your health evaluation.

Ed Draper MD
Medical Care Consultant