Carotid artery disease is a condition that causes the carotid arteries to get narrow or blocked. The carotid arteries are 2 large blood vessels on each side of the neck. These blood vessels bring blood to the brain and eyes. A narrowing or blockage of a carotid artery can slow or stop blood flow to the brain. It can cause temporary symptoms, such as dizziness, partial blindness, or numbness. It can also cause stroke or death.
The usual cause of a partial or complete blockage is a condition called atherosclerosis. Commonly known as hardening of the arteries, atherosclerosis is caused by a buildup of plaque on the inside walls of the arteries. Plaque is made up of scar tissue, blood cells that have moved from the bloodstream into the artery wall, cholesterol, and other fatty substances.
The buildup of plaque narrows the arteries and slows the flow of blood. Plaque may break off. A blood clot may form at the site of the break. The blood clot can block blood flow to the brain even more. Pieces of the clot may break away and float to the brain's smaller arteries, causing a stroke when they block these arteries.
Most people with carotid artery disease have no symptoms. When the disease causes symptoms, the risk of a major stroke increases.
The most common symptoms are transient ischemic attacks (TIAs). TIAs can cause temporary decreases in blood flow to part of the brain, causing temporary symptoms such as:
People who have had a TIA are more likely to have a stroke. A stroke happens when part of the brain is damaged by a lack of blood and there is a loss of brain function. A stroke causes symptoms such as paralysis of an arm or leg, vision and speech problems, and personality changes. Strokes are the third leading cause of death in the US.
It is important to tell your healthcare provider if you have had temporary problems with vision or minor paralysis. A routine physical exam usually detects carotid artery disease, even if you have no symptoms. Your provider may hear a murmur by listening to the carotid artery in your neck with a stethoscope. The murmur is caused by blood moving through a narrowed part of the artery.
Tests you may have are:
If you have some blockage of a carotid artery but no symptoms, the usual treatment is medicine. Your healthcare provider may prescribe medicine that helps prevent blood clots. An aspirin a day is the treatment most healthcare providers recommend. Aspirin reduces the tendency of blood to form a clot and lowers the chance of stroke.
If you have symptoms but less than a 70% blockage of a carotid artery, you will probably need a cerebral arteriogram. If this test shows no other problems, you will start aspirin treatment. If the plaque looks rough and irregular on the X-ray, your healthcare provider might recommend surgery because the irregular plaque might form clots, possibly causing a stroke.
If you have symptoms and more than a 70% blockage of a carotid artery, you will likely need surgery. The surgery, called carotid endarterectomy, involves making cuts in your neck and the artery and then removing the blockage.
Carotid angioplasty and stenting is another treatment used in some hospitals. It involves passing a balloon-tipped tube (catheter) into the carotid artery blockage. Once the catheter is in the proper place, the balloon is inflated. The balloon stretches the narrowed artery and expands the stent. After the stent is fully expanded, the balloon is deflated, and the catheter and balloon are withdrawn. The stent stays behind to keep the blood vessel open so blood can flow through it more easily.
Carotid artery disease cannot be completely eliminated, but you can control it. The goal of treatment is to prevent more blockage and stroke. Both aspirin and surgery reduce but do not entirely eliminate the risk of stroke.
Follow the treatment plan prescribed by your healthcare provider.
Call your provider right away if:
In almost all cases, atherosclerosis is the cause of carotid artery disease. You can help prevent atherosclerosis by following these guidelines:
