Is Carotid Artery Disease?
Your carotid arteries are the major blood vessels that deliver
blood to your brain. One carotid artery is located on each side of your neck.
When your doctor puts their hands on your neck to detect a pulse, they’re
feeling one of your carotid arteries.
Carotid artery disease (CAD) occurs when a blockage in one or
both of these arteries decreases the amount of blood flow to your brain. This
can lead to a stroke.
According to the Centers
for Disease Control and Prevention (CDC), more than 795,000 people have a
stroke every year in the United States. Most of these strokes are either caused
by CAD or atrial fibrillation, which
is an irregular heartbeat. CAD causes more than
half of all strokes in the United States.
Causes Carotid Artery Disease?
CAD is typically caused by atherosclerosis, a disease in which
plaque builds up in the arteries. A similar buildup occurs in the heart’s blood
vessels when someone has coronary artery disease. Plaque contains clumps of:
- cellular waste
Atherosclerosis can make your carotid arteries narrower and less
flexible over time, which limits the amount of blood flow to your organs.
CAD can also be the result of other diseases that cause arterial
Factors for Carotid Artery Disease
Some conditions can damage your arteries and put you at increased
risk of CAD:
blood pressure can weaken your artery walls and make them more
likely to become damaged.
cholesterol is a major risk factor for atherosclerosis.
- Diabetes can affect your body’s ability to
process blood sugar. It increases your risk of high blood pressure and
- Obesity increases
your risk of diabetes, high blood pressure, and atherosclerosis.
inactivity contributes to high blood pressure, diabetes, and
- Smoking can
irritate the lining of your arteries. It can also increase your heart rate and
age makes your arteries stiffer and more susceptible to damage.
- A family history of atherosclerosis is associated with
increased CAD risk.
of Carotid Artery Disease
Early CAD rarely causes symptoms. Symptoms are only likely to
appear once one of your carotid arteries has become fully blocked or nearly
blocked. A carotid artery is usually considered nearly blocked when it’s more
than 80 percent blocked.
At that point, you’re at high risk for a transient ischemic attack (TIA)
or a stroke. A TIA is also known as a mini-stroke because it causes stroke
symptoms that last from a few minutes to a few hours. These symptoms include:
- sudden weakness or numbness in the face, arms,
or legs (usually on one side of the body)
- trouble speaking (garbled speech) or
- sudden vision problems in one or both eyes
- sudden, severe headache
- numbness or weakness in your limbs
- numbness in one side of your face
- drooping on one side of your face
Call 911 or go to the emergency room immediately if you
experience any of these symptoms. They could be signs of a medical emergency.
for Carotid Artery Disease
If you fall into a high-risk group for CAD, your doctor will want
to test you for early signs of damage. During
a physical exam, your doctor will listen to the arteries in your
neck with a stethoscope for a swishing sound called a bruit. This is a sign
that there’s a potential narrowing in your carotid vessels. Your doctor may
also test your strength, memory, and speech.
There are additional tests that can be used to detect CAD.
This noninvasive test uses sound waves to measure the flow and
pressure of blood in your vessels.
Computed Tomography Angiography (CTA or CT Angiography)
This is a way to take X-ray images of your vessels. A dye called contrast is placed in your vessels.
The CT scanner then takes pictures from several angles.
Head CT Scan
This procedure takes pictures of your brain tissue to check for
any bleeding or abnormalities.
Magnetic Resonance Angiography (MRA)
This test also uses contrast to highlight arteries in your neck
and brain. Then, 3-D images are taken using a high-powered magnet.
This test takes detailed images of brain tissue without using
In this test, your doctor will insert a thin, flexible tube
called a catheter into your carotid artery. Dye will be injected, and then an
X-ray will be taken to view any abnormalities. This test is more invasive than
the other forms of imaging. Therefore, it’s riskier.
Are the Complications Associated with Carotid Artery Disease?
A stroke is the main potential complication of CAD. A stroke
occurs when the blood flow to the brain is interrupted. This can lead to loss
of brain function or even death.
There are several ways that CAD can cause a stroke:
- Narrowed carotid arteries may not supply enough
blood to the brain.
- A piece of plaque can break off and lodge in one
of the smaller arteries of your brain, blocking blood flow.
- Blood clots can form in your carotid artery,
blocking blood flow.
- Blood clots can break off from inside your
carotid artery and block a smaller artery in your brain.
Is Carotid Artery Disease Treated?
Your doctor will base your treatment plan on your symptoms and
whether or not you’ve had a stroke.
If you’re diagnosed with CAD before you have a stroke, your
doctor will suggest you make preventive lifestyle changes. These include:
- quitting smoking if you smoke
- exercising regularly
- eating healthy food
- managing any chronic conditions, such as heart
disease and diabetes
- taking medications as prescribed
The treatment is more invasive if you’re diagnosed with CAD after
having a stroke. Your doctor may need to open your carotid artery to remove the
blockage. There are two different ways to do this.
Carotid endarterectomy is
the most common form of surgery for severe CAD. After your anesthesiologist gives
you local or general anesthesia, your doctor will make an incision on the front
of your neck. Your doctor will open your carotid artery and remove any
blockages. Your doctor will then stitch the artery closed. This is a relatively
low-risk procedure that can have a lasting effect on preventing strokes.
Your doctor will use a carotid
artery stent if the blockage is inconveniently located, you have a large
blockage, or you have other serious health problems that make you a high-risk
surgical candidate. A stent is a small wire coil. In this procedure, your
doctor uses a balloon to widen a narrowed section of the artery. They then
place a stent inside to keep the artery open.
Outlook for Carotid Artery Disease
Your long-term outlook will depend on the extent of your disease.
However, there are things you can do to improve your health. These include:
- regularly checking your blood pressure
- testing your blood sugar and cholesterol levels
one to two times per year
- taking a yearly carotid Doppler ultrasound test
(if you’ve had a prior stroke), which is a short, painless test that allows
your doctor to see the blood flow through your carotid arteries
- attending regular checkups with your doctor
Carotid Artery Disease Be Prevented?
There are steps you can take to decrease your chances of developing
smoking can reduce your stroke risk to that of someone who doesn’t
smoke within a few years.
cholesterol and fat in your diet will reduce your risk of
regular exercise helps lower blood pressure, increase good
cholesterol levels, and improve heart health.
- Reducing alcohol consumption may improve your
a healthy weight can reduce your risk of developing CAD.
Managing diabetes and other chronic health conditions is
also a great way to reduce your risk of long-term complications, such as CAD or
stroke. Talk to your doctor about the best way to maintain the health of your
heart and blood vessels.