Carotid artery disease , also called carotid artery stenosis, occurs when the carotid arteries, the main blood vessels that carry oxygenated blood to the brain, become narrowed. The narrowing of the carotid arteries is most commonly related to atherosclerosis (a build-up of plaque, which is a deposit of fatty substances, cholesterol, cellular waste products, calcium and fibrin in the inner lining of an artery). Atherosclerosis, or "hardening of the arteries," is a vascular disease (disease of the arteries and veins). Carotid artery disease is similar to coronary artery disease, in which blockages occur in the arteries of the heart, and may cause a heart attack.
Risks of Carotid Artery Disease
- older age
- family history
- race or ethnicity
- genetic factors
- hyperlipidemia (elevated fats in the blood)
- hypertension (high blood pressure)
- diet high in saturated fat
- lack of exercise
Risks of carotid artery disease include anything that may increase a person's chance of developing a disease. It may be an activity, such as smoking, diet, family history or many other things. Different diseases have different risk factors.
Although these factors increase a person's risk of carotid artery disease, they do not necessarily cause the disease. Some people with one or more risk factors never develop carotid artery disease, while others develop disease and have no known risk factors. Knowing your risk factors to any disease can help to guide you into the appropriate actions, including changing behaviors and being clinically monitored for the disease.
Symptoms of Carotid Artery Disease
Carotid artery disease may be asymptomatic (without symptoms) or symptomatic (with symptoms). Asymptomatic carotid disease is the presence of a significant amount of atherosclerotic build-up without obstructing enough blood flow to cause symptoms. Symptoms of carotid artery disease (or symptomatic carotid artery disease) may result in either a transient ischemic attack (TIA) and/or a stroke (brain attack).
A transient ischemic attack (TIA) is a sudden or a temporary loss of blood flow to an area of the brain, usually lasting less than five minutes but not longer than 24 hours, with complete recovery. Symptoms of a TIA may include, but are not limited to, the following:
- sudden weakness or clumsiness of an arm and/or leg on one side of the body
- sudden paralysis (inability to move) of an arm and/or leg on one side of the body
- loss of coordination or movement
- confusion, dizziness, fainting and/or headache
- numbness or loss of sensation (feeling) in the face
- numbness or loss of sensation in an arm and/or leg
- temporary loss of vision or blurred vision
- inability to speak clearly or slurred speech
Diagnosis of Carotid Artery Disease
In addition to a complete medical history and physical examination, the diagnosis of carotid artery disease may include any, or a combination, of an auscultation of carotid arteries, carotid artery duplex scan, MRI, MRA, CT scan or angiography.
Your doctor will review your complete medical and family history and perform a physical examination. As part of the examination, the doctor will listen to your carotid arteries with a stethoscope for bruits, which are swooshing sounds that may indicate changes in your blood flow. They will determine whether you have any major risk factors for carotid artery disease. They will also evaluate any signs or symptoms of a mini-stroke or stroke. Your doctor may then order several tests to diagnose your condition and the severity of the condition. Those tests may include an auscultation of carotid arteries, carotid artery duplex scan, MRI, MRA, CT scan or angiography.
Carotid Artery Disease Treatment
Carotid artery disease treatment may include modification of risk factors or medications. Surgical treatment of carotid artery disease includes a carotid endarterectomy or carotid artery angioplasty with stenting.
Specific carotid artery disease treatment will be determined by your physician based on:
- your age, overall health and medical history
- extent of the disease
- your signs and symptoms
- your tolerance of specific medications, procedures or therapies
- expectations for the course of the disease
- your opinion or preference