Carotid artery disease: Symptoms, Treatment

Overview

Carotid artery disease, also known as carotid artery stenosis, means the narrowing of the carotid arteries. The carotid arteries are responsible for blood supply to the head. Usually, it is caused by atherosclerosis, the hardening of the arteries due to the plaque buildup. In severe cases, the accumulation of plaque can lead to stroke for it causes narrowing or blockage in the carotid artery.

According to the Centers for Disease
Control and Prevention (CDC), more than 795,000 people have a stroke every year
in the United States. It is noted that more than half of these stroke cases are
caused by carotid artery disease.

Causes

Carotid artery disease occurs because of damage to the inner lining of the artery, which facilitates the buildup of plaques in the artery. Plaques are clumps of cholesterol, calcium, fibrous tissue and other cellular debris that gather at injury sites within the artery. This process is called atherosclerosis, leading to the block of blood flow to the head. Clogged carotid arteries have trouble delivering oxygen and nutrients to vital brain structures.

Factors that can increase your risk of
carotid artery disease include:

  • Age

As you age, your arteries become less
flexible and more prone to injury.

  • Family history

If you have a relative who has atherosclerosis or coronary artery disease, your risk of developing carotid artery disease is higher.

Excess pressure on artery walls can weaken
them and make them more susceptible to damage.

  • Smoking

Nicotine can irritate the inner lining of
your arteries. Furthermore, smoking may increase your heart rate and blood
pressure.

Diabetes can lower your ability to process
fats efficiently, placing you at greater risk of high blood pressure and
atherosclerosis.

  • Obesity

Excess weight increases your chances of high blood pressure, atherosclerosis, and diabetes.

  • Lack of exercise

It may aggravate conditions that damage your arteries, including high blood pressure, diabetes, and obesity.

Symptoms

In the early stage, carotid artery disease rarely causes symptoms. When your carotid arteries are fully blocked or nearly blocked, stroke and transient ischemic attack (TIA), which is known as a ministroke, may occur. Signs and symptoms of a stroke or TIA include:

  • Sudden weakness or numbness in the face, or limbs
  • Sudden trouble speaking or understanding
  • Sudden vision problems in one or both eyes
  • Sudden dizziness or confusion
  • Loss of coordination
  • Sudden and severe headache
  • Problems with memory
  • Drooping on one side of your face

If you experience any of these symptoms,
call your doctor immediately, because this may be the sign of a medical
emergency.

Diagnosis

Often, carotid artery disease manifests no
symptoms until you have a stroke or TIA. So, regular physical exams are quite important
to discover the condition as early as possible. Your doctor may listen to the
arteries in your neck with a stethoscope. If an abnormal sound is heard over an
artery, it may indicate carotid artery disease.

In addition to a physical exam, tests that
can help your doctor diagnosis carotid artery disease include:

  • Standard or Doppler ultrasound to look for plaques and blood clots in the carotid arteries and show the movement of blood through the blood vessels
  • Magnetic resonance angiography (MRA) to show high-resolution images of the brain and arteries
  • Computerized tomography angiography (CTA) to reveal damage in the carotid arteries
  • Carotid angiogram to let a doctor see blood flow through the carotid arteries in real time for signs of narrowing or blockages

Treatment

Depending on whether you have had a stroke or not, treatment may be different for you. Generally, options for treating carotid artery disease are the combination of lifestyle changes, medication, and surgery.

If your doctor confirms a carotid artery disease diagnosis before you have a stroke, he or she will suggest you to make preventive lifestyle changes to slow the progression of the disease, such as:

  • Avoiding smoking if you do
  • Doing more exercises
  • Eating a healthy diet
  • Maintaining a healthy weight
  • Managing any chronic conditions, such as heart disease and diabetes

Medications are prescribed to control blood pressure or lower cholesterol, including aspirin and other blood-thinning drugs. If the patient was already taking aspirin and still experienced a TIA, the next line medication may be dipyridamole/aspirin combination (Aggrenox) or clopidogrel (Plavix).

If you already experienced a stroke or TIA,
surgical treatment is more recommended.
Under normal conditions, there are two surgical options for treating carotid
artery disease. They are:

  • Carotid endarterectomy

This is the most common form of surgery for
severe carotid artery disease. It is done by opening your carotid artery and
remove any blockages. This procedure can have a lasting effect on preventing
strokes.

  • Carotid artery angioplasty and stent

This is another option when the blockage is too difficult to reach with carotid endarterectomy or you have other health conditions that make surgery too risky. In this procedure, you are given local anesthesia and a tiny balloon is threaded by catheter to the area of the clog. The balloon is inflated to widen the artery, and then a small wire mesh coil (stent) is inserted to keep the artery from narrowing again.



Keywords: carotid artery disease; carotid artery stenosis.

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