Carotid artery stenosis, also called carotid artery disease, is a narrowing of the carotid arteries. This narrowing may lead to partial or complete blockage of one or both of the carotid arteries, causing a stroke. A stroke is a life-threatening event in which the brain's vital supply of blood and oxygen is disrupted.
Causes of Carotid Artery Stenosis
Carotid artery stenosis occurs due to narrowing of the arteries from a gradual build up of plaque. Plaque forms when cholesterol, fat and other substances line the inside walls of the arteries and build up over time causing a blockage.
Symptoms
You may have some of the following symptoms or you may not have any symptoms at all.
- light-headedness
- blurred vision
- dizziness
- weakness on one side of body
- headache
Diagnosing Carotid Artery Stenosis
If you are experiencing one or more of the above symptoms, it is important to seek medical advice immediately for an evaluation. Because some people may not have symptoms at all, it is important to schedule regular physician appointments with your doctor.
Your doctor may hear an abnormal sound over your carotid artier when listening with a stethoscope. This is called a bruit (broo'-ie). The doctor may order a carotid artery ultrasound. This non-invasive diagnostic test takes images of the blood flowing through the arteries and it can detect narrowing from plaque.
Carotid Angiography
The most common way to diagnose carotid artery stenosis is with angiography. This test feeds a catheter from your groin, through your aorta and into the carotid artery. An injectable contrast dye is then inserted into the artery while images of the area are captured. This dye allows your doctor to view the arteries in a more enhanced field of view to detect any stenosis or narrowing.
Treating Carotid Artery Stenosis
Medications
For a blockage of less than 50% of the artery, your doctor may prescribe anti-clotting medications to reduce the risk of stroke.
Carotid Endarterectomy
This is an open surgical procedure commonly performed by a neurosurgeon or vascular surgeon. A small incision is made just below the jaw-line to expose the carotid artery at the site of the stenosis. After placing a temporary shunt tube to redirect the blood flowing through the affected artery, the surgeon removes the plaque that is causing the carotid artery to be narrow or blocked.
Carotid Angioplasty/Stenting
A neuroradiologist uses diagnostic imaging to insert a special catheter through one of the main arteries in the groin, through your aorta (the major blood vessel of your heart) to the blockage in the carotid artery. The doctor then attempts to clear the blockage and open the artery up. This is an alternative to open surgery for patients who are elderly or who have other health issues like heart or lung disease, carotid disease on both sides, prior radiation therapy to the neck or prior carotid surgery.