Carotid Artery Disease

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The Carotid Arteries

There are two carotid arteries, which are the two primary vessels supplying oxygenated blood to the neck, face, and brain. When plaque builds up in the carotid arteries over time, a stroke can occur. If a section of plaque breaks open, the resulting blood clot can also cause a stroke.

Quick Facts

  • Carotid artery disease occurs when fatty deposits (plaque) block the carotid arteries.
  • When plaque clogs the carotid arteries, the delivery of oxygen and nutrients to your brain is adversely affected. 
  • Carotid artery disease increases the risk of stroke, which occurs when blood supply to the brain is severely reduced or interrupted. 
  • Depending on how severe the blockage is, lifestyle changes, medication, or even medical procedures may be needed.

Symptoms

Carotid artery disease may not show any symptoms until the arteries are severely blocked or narrowed.

The first sign of the disease is a transient ischemic attack (TIA), a mini-stroke that resolves within a few hours to a day.

TIA has symptoms similar to a stroke, such as numbness in the arms, neck or face, dizziness, blurred vision, and slurred speech or trouble understanding others.

As a mini-stroke precedes a full-blown stroke, which may occur as early as a few days after the mini-stroke, immediate medical attention becomes necessary.

Causes and Risk Factors

Atherosclerosis is the primary cause of carotid artery disease. People with coronary heart disease have an increased risk of developing carotid artery disease. 

Carotid artery disease shares many of the same risk factors as coronary heart disease and peripheral artery disease, including:

  • Smoking
  • Diabetes
  • Metabolic disorders
  • High blood pressure
  • High blood cholesterol levels
  • Obesity

Men aged 75 years and younger are at a greater risk than women in this age group. Over the age of 75, women are more susceptible than their male counterparts. 

Diagnosis

Your doctor will evaluate your symptoms, risk factors, and medical history.

To check the speed of blood flow within your carotid arteries, your doctor may listen to them using a stethoscope. A “whooshing” sound heard through a stethoscope, called a bruit, is an indication of low or disturbed blood flow within the arteries.

Based on your medical history and physical examination, your doctor may order the following diagnostic tests:

  • Carotid Duplex Ultrasound – A test combining traditional and Doppler ultrasound to detect blockages in carotid arteries. 
  • Arteriogram – A test where a contrast dye is injected into an artery to produce images of your blood vessels on an X-ray. 

Treatment Options

Medications

This can include aspirin or clopidogrel, which prevents platelets (disk-shaped cells) from clumping together and obstructing the carotid arteries.

Coronary Interventions

These may be needed if the narrowed carotid artery cause symptoms. Such interventions are:

  • Carotid endarterectomy: carried out for blockages of 50% or more. This involves making an incision at the front of your neck, opening the problematic carotid artery, and removing the plaque. 
  • Angioplasty and stenting: where a catheter-guided balloon is used to put a metal stent in place and is then expanded to flatten the plaque and widen the artery. 

Lifestyle Changes

These can lower the risk of stroke. Getting your blood pressure and diabetes under control, shedding excess weight, keeping your BMI in check, quitting smoking, and reducing alcohol intake are the recommended lifestyle modifications to pursue.

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