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The carotid arteries are the two large blood vessels at each side of the neck. Carotid artery stenosis (narrowing) occurs when the carotid arteries become narrow or blocked by carotid artery disease.
The carotid arteries are the main supply of blood to the brain. The most common cause of blockage in these arteries is atherosclerosis, in which fatty materials collect under the inner lining of the arterial wall.
Risk Factors
The risk of developing carotid artery stenosis increases with high blood pressure, high blood cholesterol levels, high stress levels, diabetes mellitus, diabetes, cigarette smoking, obesity, lack of exercise, and advanced age.
Signs & Symptoms
Most people with carotid artery stenosis have no symptoms, but if symptoms such as partial paralysis, blindness, or feelings of numbness are present, there is great risk of a major stroke. Carotid artery stenosis can also cause transient ischemic attacks (TIAs), also called "mini strokes." With a TIA, small pieces of the fatty materials in the arteries break away and lodge in the small blood vessels leading to the vein. This blocks the blood supply to the brain temporarily and results in symptoms such as blindness in one eye, numbness and tingling of the skin, and weakness of an arm or a leg. TIAs usually last anywhere from 2 to 30 minutes. These symptoms are temporary and reversible, but people who have TIAs are more likely to have a stroke.
Diagnosis & Tests
Carotid artery disease is usually detected during a routine physical examination. Your doctor will be able to hear the blood rushing past the blockage in the carotid artery by listening with a stethoscope. An ultrasound test is used to create pictures of the blockage and to measure the amount of blood flowing through the artery. Another frequently used diagnostic test is called a cerebral arteriogram. A special dye is injected into an artery. An X-ray then shows the location and size of the blockage, which are revealed by the path the dye is able to take. If your doctor suspects a stroke, he or she may also order a computed tomography (CT) scan of your head to check brain function. It is important to tell your doctor if you have had any recent episodes of loss of vision or minor paralysis.
Treatment & Prevention
The treatment for carotid artery stenosis depends upon the degree of blockage and the presence of symptoms. If the carotid artery is less than 70% blocked and there are no symptoms, doctors usually recommend aspirin treatment. One aspirin per day will reduce the likelihood of a blood clot and decrease the chance of stroke. Treatment will include regular checkups with your doctor to see if your condition changes.
If the carotid artery is less than 70% blocked, but you have symptoms, the treatment depends upon the results of the cerebral arteriogram. If this test shows no other problems, patients are usually started on daily aspirin treatment. Again, treatment will include regular checkups for any changes in your condition. However, if the plaque looks rough and irregular, your doctor may recommend surgery to remove the plaque.
If the carotid artery is more than a 70% blocked and you have symptoms, the usual treatment is surgery. This procedure, called carotid endarterectomy, involves removing the plaque from the carotid artery. You are placed under general anesthesia and the surgeon makes a small cut (incision) in your neck to expose the artery. He or she then makes a cut in the artery and removes the blockage. The artery is repaired and the incision in your neck is closed with stitches. Following the surgery, you may need to take medicine that makes your blood less likely to clot. There is a 1-2% risk of stroke with this procedure. Another promising procedure is called carotid angioplasty. With this procedure, the area around the carotid artery is numbed with a local anesthetic. Then, a long, thin tube, called a catheter, is passed into the carotid artery in the area of the blockage. The catheter has a balloon on its tip. When the balloon is inflated, it stretches and opens the blocked artery.
You can help prevent carotid artery stenosis and stroke by following recommendations for preventing atherosclerosis. This means following a diet that is low in fat and cholesterol, exercising regularly, maintaining a healthy weight, and avoiding cigarette smoking.
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Signs, symptoms & indicators of Carotid Artery Disease:
Conditions that suggest Carotid Artery Disease:
Recommendations and treatments for Carotid Artery Disease:
KEY | | Strong or generally accepted link |  | | Likely to help |
GLOSSARY
Anesthesia
Loss of sensation caused by neurological dysfunction or a pharmacological depression of nerve function.
Anesthetic
Agent causing loss of sensation by neurological dysfunction or a pharmacological depression of nerve function.
Arterial (Arteries, Artery)
Blood that leaves the heart. When it leaves the right ventricle, it is venous blood; and when it leaves the left ventricle, through the aorta, it is fresh and oxygenated. After it has passed out to the capillaries and started to return, it is venous blood.
Atherosclerosis
Common form of arteriosclerosis associated with the formation of atheromas which are deposits of yellow plaques containing cholesterol, lipids, and lipophages within the intima and inner media of arteries. This results in a narrowing of the arteries, which reduces the blood and oxygen flow to the heart and brain as well as to other parts of the body and can lead to a heart attack, stroke, or loss of function or gangrene of other tissues.
Checkup (Check-up, Checkups, Check-ups)
A thorough physical examination that includes a variety of tests depending on the age, sex and health of the person.
Cholesterol
A waxy, fat-like substance manufactured in the liver and found in all tissues, it facilitates the transport and absorption of fatty acids. In foods, only animal products contain cholesterol. An excess of cholesterol in the bloodstream can contribute to the development of atherosclerosis.
Computerised Tomography (CAT Scan, Computed Tomography, Computerized Axial Tomography, CT Scan)
A scanning procedure using X-rays and a computer to detect abnormalities of the body's organs. This technique provides cross-sectional images of body organs, which is much clearer than those provided by conventional X-rays.
Diabetes Mellitus (Diabetes, Diabetic, Diabetics)
A disease with increased blood glucose levels due to lack or ineffectiveness of insulin. Diabetes is found in two forms; insulin-dependent diabetes (juvenile-onset) and non-insulin-dependent (adult-onset). Symptoms include increased thirst; increased urination; weight loss in spite of increased appetite; fatigue; nausea; vomiting; frequent infections including bladder, vaginal, and skin; blurred vision; impotence in men; bad breath; cessation of menses; diminished skin fullness. Other symptoms include bleeding gums; ear noise/buzzing; diarrhea; depression; confusion.
Ischemia (Ischemic)
Localized tissue anemia due to obstruction of the inflow of arterial blood. A decrease in the blood supply to a bodily organ, tissue, or part caused by constriction or obstruction of the blood vessels.
Stenosis
Usually referring to Esophageal or GI tract: Narrowing.
Stroke (Stroke-Type Event)
A sudden loss of brain function caused by a blockage or rupture of a blood vessel that supplies the brain, characterized by loss of muscular control, complete or partial loss of sensation or consciousness, dizziness, slurred speech, or other symptoms that vary with the extent and severity of the damage to the brain. The most common manifestation is some degree of paralysis, but small strokes may occur without symptoms. Usually caused by arteriosclerosis, it often results in brain damage.
Ultrasound
Ultrasound testing uses sound waves projected into the body to produce an image of internal organs, structures, tumors, etc. In this procedure, a gel is applied to the patient's skin, and a small device that emits ultrasonic pulses is slowly passed over the area. The sonic image produced is viewed on a monitor.
Vitamin C (Ascorbic Acid)
A water-soluble antioxidant vitamin essential to the body's health. When bound to other nutrients, for example calcium, it would be referred to as "calcium ascorbate". As an antioxidant, it inhibits the formation of nitrosamines (a suspected carcinogen). Vitamin C is important for maintenance of bones, teeth, collagen and blood vessels (capillaries), enhances iron absorption and red blood cell formation, helps in the utilization of carbohydrates and synthesis of fats and proteins, aids in fighting bacterial infections, and interacts with other nutrients. It is present in citrus fruits, tomatoes, berries, potatoes and fresh, green leafy vegetables.
X-rays (X-ray)
High-energy radiation used to take pictures of areas inside the body.
Last updated: Apr 13, 2008
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