Carotid Artery Disease

The carotid arteries are the two main arteries on either sides of the neck that supply blood to the brain. Carotid artery disease, also called carotid artery stenosis, is the narrowing or blockage of one or both carotid arteries. Carotid artery disease increases your risk for a stroke or a transient ischemic attack (TIA). A TIA is an episode in which a waxy, fatty substance that accumulates within the artery (plaque) blocks blood flow to the brain. A TIA is considered a "warning stroke."

CAUSES

  • Atherosclerosis (common). Atherosclerosis is a disease in which plaque builds up inside the carotid arteries.

  • Aneurysm. This is a weakened outpouching in an artery.

  • Arteritis. This is inflammation of the carotid artery.

  • Fibromuscular dysplasia. This is a fibrous growth within the carotid artery.

  • Post-radiation necrosis. This is tissue death within the carotid artery due to radiation treatment.

  • Vasospasm. This is decreased blood flow due to spasms of the carotid artery.

  • Carotid dissection. This is separation of the walls of the carotid artery.

RISK FACTORS

  • High cholesterol (dyslipidemia).  

  • High blood pressure (hypertension).  

  • Smoking.  

  • Obesity.  

  • Diabetes.  

  • Family history of cardiovascular disease.  

  • Inactivity or lack of regular exercise.  

  • Being male. Men have an increased risk of developing atherosclerosis earlier in life than women.  

SYMPTOMS

Carotid artery disease does not cause symptoms.

DIAGNOSIS

Diagnosis of carotid artery disease may include:

  • A physical exam. Your health care provider may hear an abnormal sound (bruit) when listening to the carotid arteries.  

  • Specific tests that look at the blood flow in the carotid arteries. These tests include:  

  • Carotid artery ultrasonography.  

  • Carotid or cerebral angiography.  

  • Computerized tomographic angiography (CTA).  

  • Magnetic resonance angiography (MRA).  

TREATMENT

Treatment of carotid artery disease can include a combination of treatments. Treatment options include:

  • Surgery. You may have:  

  • A carotid endarterectomy. This is a surgery to remove the blockages in the carotid arteries.  

  • A carotid angioplasty with stenting. This is a nonsurgical interventional procedure. A wire mesh (stent) is used to widen the blocked carotid arteries.  

  • Medicines to control blood pressure, cholesterol, and reduce blood clotting (antiplatelet therapy).  

  • Adjusting your diet.  

  • Lifestyle changes such as:  

  • Quitting smoking.  

  • Exercising as tolerated or as directed by your health care provider.  

  • Controlling and maintaining a good blood pressure.  

  • Keeping cholesterol levels under control.  

HOME CARE INSTRUCTIONS

  • Take medicines as directed by your health care provider. Make sure you understand all your medicine instructions. Do not stop your medicines without talking to your health care provider.  

  • Follow your health care provider's diet instructions. It is important to eat a healthy diet that is low in saturated fats and includes plenty of fresh fruits, vegetables, and lean meats. High-fat, high-sodium foods as well as foods that are fried, overly processed, or have poor nutritional value should be avoided.

  • Maintain a healthy weight.  

  • Stay physically active. It is recommended that you get at least 30 minutes of activity every day.  

  • Do not smoke.  

  • Limit alcohol use to:  

  • No more than 2 drinks per day for men.  

  • No more than 1 drink per day for nonpregnant women.  

  • Do not use illegal drugs.  

  • Keep all follow-up appointments as directed by your health care provider.  

SEEK IMMEDIATE MEDICAL CARE IF:

If you develop TIA or stroke symptoms. These include:

  • Sudden weakness or numbness on one side of the body, such as in the face, arm, or leg.  

  • Sudden confusion.  

  • Trouble speaking (aphasia) or understanding.  

  • Sudden trouble seeing out of one or both eyes.  

  • Sudden trouble walking.  

  • Dizziness or feeling like you might faint.  

  • Loss of balance or coordination.  

  • Sudden severe headache with no known cause.  

  • Sudden trouble swallowing (dysphagia).  

If you have any of these symptoms, call your local emergency services (911 in U.S.). Do not drive yourself to the clinic or hospital. This is a medical emergency.