Understanding Carotid Artery Disease: A Q&A with Dr. Maksim V. Gusev

Carotid artery disease is one of the leading causes of stroke in the United States, yet many people don’t realize they have it until it becomes serious. To help patients better understand this condition, we sat down with Dr. Maksim V. Gusev, a Fellowship-trained, Board-Certified Vascular Surgeon with Premier Surgical Associates in Knoxville, TN.

Dr. Gusev specializes in both vascular and endovascular surgery, performing procedures such as angioplasty, carotid artery surgery, and abdominal aortic aneurysm repair. Here, he explains what you need to know about carotid artery disease, its risks, and treatment options.

What is Carotid Artery Disease?

Dr. Gusev:
Carotid artery disease occurs when plaque builds up in the carotid arteries—the major blood vessels in your neck that supply blood to your brain. Over time, this buildup can break off and travel to the brain, potentially causing a debilitating stroke, paralysis, or even death.

How Do You Know if You Have Carotid Artery Disease?

Dr. Gusev:
The tricky part is that carotid disease is often silent. You won’t feel pain in your neck, and you can’t detect the plaque with your fingers. Symptoms usually appear only when it becomes serious, often in the form of mini-strokes (TIAs). Warning signs include sudden weakness on one side of the body, facial drooping, loss of vision, or temporary paralysis.

What Should You Do if You Notice These Symptoms?

Dr. Gusev:
This is a medical emergency. If you experience sudden weakness, slurred speech, or vision loss in one eye, go to the emergency department immediately. Doctors will check for stroke and evaluate your carotid arteries for blockages.

Who is at Risk for Carotid Artery Disease?

Dr. Gusev:
Your primary care doctor often detects risk by listening to your neck with a stethoscope for abnormal blood flow sounds, called a bruit. Risk factors include:

• Smoking
• Older age
• Diabetes
• High cholesterol
• High blood pressure

If you have these risk factors, it’s important to be screened.

What Treatment Options Are Available?

Dr. Gusev:
Treatment depends on your age, overall health, and where the plaque is located. The two main surgical options are:

• Carotid endarterectomy – surgically opening the artery, removing the plaque, and patching the vessel.
• Carotid stenting – using a stent to widen the artery and improve blood flow.

Are There Medications for Carotid Artery Disease?

Dr. Gusev:
Yes. In addition to surgery, most patients should be on antiplatelet therapy (such as aspirin, if safe), cholesterol-lowering medications (statins), and have well-controlled blood pressure. These are essential whether or not surgery is needed.

What’s the Most Important Thing for Patients to Remember?

Dr. Gusev:
If you ever experience sudden weakness, paralysis, or sudden blindness in one eye, think of your carotid arteries. Prompt evaluation and treatment can prevent a life-changing or life-threatening stroke.

Expert Vascular Care in Knoxville, TN

At Premier Vascular & Vein Center, our fellowship-trained vascular surgeons, including Dr. Gusev, provide advanced treatment options for carotid artery disease and other vascular conditions. If you have risk factors or symptoms, talk with your doctor or request a consultation online with our team or call our office at (865) 588-8229.