Carotid Artery Disease
Carotid artery stenosis occurs when the carotid artery, the large artery on either side of the neck, becomes obstructed.
The obstruction is composed of a substance called plaque (fatty cholesterol deposits).
When plaque obstructs the normal flow of blood through the carotid artery, the risk of stroke increases.
Plaque accumulation is known as atherosclerosis.
One carotid artery is located on each side of your neck.
These are the large arteries that supply the brain, face, and head with blood.
When these arteries are healthy, they are smooth and open, like a clean pipe that allows fluid to flow freely without obstruction.
The circulatory system of your body is a network of tubes that transport blood (containing nutrients and oxygen) to all of your body’s cells.
Carotid artery stenosis can develop in either of the two arteries in your neck, or in both.
This condition can worsen over time in the absence of medical treatment, leading to a stroke with potentially fatal complications.
Symptoms of Carotid Artery Disease
A stroke can be caused by carotid artery stenosis. Plaque fragments (or platelets that form on plaque) typically travel to the brain when carotid stenosis is the cause of a stroke. It is known as a “ischemic” stroke because a portion of the brain’s blood supply is cut off. When this obstruction becomes permanent, brain cells and neurons begin to die.
A transient ischemic attack (TIA) is a “mini-stroke” caused by the temporary occlusion of a small cerebral artery by plaque and/or platelets. A TIA precedes an ischemic stroke in the majority of cases. In order to prevent cell death, it is crucial to seek treatment for these conditions as soon as possible.
Symptoms of a TIA or stroke may include the following:
- One side of your face is drooping
- Difficulty communicating with others due to slurred speech or trouble forming words.
- Loss of vision in one eye accompanied by the descent of a dark curtain across the field of vision.
- One side of your body losing sensation
- Loss of muscular strength and a weakened side of the body
If your carotid artery stenosis has not yet resulted in a stroke, you may experience no symptoms.
Causes of Carotid Artery Disease
Several factors can increase the likelihood of developing this condition over time.
Some of these are modifiable variables.
Some factors contribute to and compound others:
- Cigarette smoking and use of other tobacco products
- Having obesity
- sedentary way of life
- elevated blood pressure (hypertension)
- elevated cholesterol
- Diabetes\sAge
Diagnostics of Carotid Artery Disease
Carotid artery stenosis is frequently diagnosed after the onset of stroke symptoms. Carotid artery stenosis may be diagnosed if the symptoms prompt a thorough examination of the carotid artery for any type of blockage. During a stethoscope exam of your neck, your healthcare provider can also diagnose this condition if he or she detects an abnormal sound known as a bruit (whistling sound) or murmur. To confirm a diagnosis of carotid artery stenosis and learn more about the size and location of the blockage, providers utilize a variety of diagnostic procedures. These tests may consist of:
- Duplex ultrasound, uses sound waves to produce an image of your body’s internal structures. Ultrasound is a non-painful test that is performed on the skin. Ultrasound is used to determine how blood flows through your arteries and to identify any areas where they may be blocked or constricted.
- CTA: computed tomography angiography. Your provider can obtain a detailed image of your carotid arteries using a CT scanner, a device that uses X-rays to create an image of your internal organs. During this test, a dye is injected into your bloodstream to aid in the visualization of any blockages. This test may be administered to patients with pacemakers or stents implanted for other conditions.
- Cerebral angiography: This diagnostic procedure involves inserting a catheter into your arteries in a minimally invasive manner to examine the blockage in detail. In addition, your healthcare provider injects contrast material directly into your arteries in order to visualize the artery’s details.
- Magnetic resonance angiography (MRA): This test provides detailed images of your arteries, similar to a CT scan but without the use of X-rays. This is a noninvasive imaging procedure.
Treatment of Carotid Artery Disease
The primary objective of carotid artery stenosis treatment is to halt the disease’s progression. This begins with lifestyle changes such as a healthy diet, exercise, and quitting smoking. In addition to aspirin, medications that reduce blood pressure and cholesterol may be used.
In more severe cases and/or cases causing TIA or stroke symptoms, your provider may use a surgical procedure called carotid endarterectomy to remove the plaque from the carotid artery. Alternately, your surgeon may insert a stent through a large needle puncture and then the obstructed artery. This will restore the artery to its normal size while trapping the plaque between the stent and the wall, away from the blood flow. A vascular surgeon or specialist determines which of these procedures is optimal for each individual requiring carotid disease treatment.
Not all cases of carotid stenosis require surgical or interventional treatment due to the inherent dangers of these procedures. When the risks of severe stenosis and/or stroke are greater than the risks of the procedure, only then do surgeons recommend procedures.
