Carotid Artery Disease
What is Carotid Artery Disease?
The carotid arteries are the large blood vessels in either side of the neck that supply blood to the head and brain. In Carotid Artery Disease, fat and cholesterol deposits called plaque build up in these arteries. This is called atherosclerosis, or hardening of the arteries. Over time, this plaque narrows the arteries, decreasing blood flow to the brain and can lead to stroke. Small particles of plaque can also break loose and travel to smaller arteries, where they block blood flow and can also cause stroke.
The severity of each case depends on how large an area of the brain is affected and whether the brain’s blood supply is partially or completely blocked. But this disease is a leading cause of stroke, or brain attack. If the lack of blood flow lasts for more than three to six hours, the damage is usually permanent.
What are the risk factors for Carotid Artery Disease?
The risk factors are similar to those for coronary artery disease:
- Age (greater in men than women under the age of 75, but higher in women over age 75)
- Family history of atherosclerosis
- Smoking
- Diabetes
- Hypertension (high blood pressure)
- High levels of bad cholesterol (LDL
Also, if you have coronary artery disease, you are more likely to get carotid artery disease.
What are the symptoms for Carotid Artery Disease?
There may be no symptoms. However, there are warning signs of an impending stroke. One of the most important ones is a transient ischemic attack, or TIA, which can last a few minutes or hours. In a TIA you experience:
- Difficulty swallowing
- Dizziness or confusion
- Slurred speech, difficulty talking or understanding others
- Blurred or loss of vision in one or both eyes
- Weakness or numbness in your arm, leg or face on one side of your body
This is a serious condition and requires immediate medical attention.
How is Carotid Artery Disease diagnosed?
Because there are generally no symptoms, it is vital for those at risk to have regular physical exams. Your physician should listen to your carotid arteries with a stethoscope to detect any abnormal rushing sound that may indicate you have this disease. If you have any of the symptoms above, tell your physician. Diagnostic tests to be considered include:
- Carotid angiogram – A catheter is inserted into a blood vessel in an arm or leg, guided to the carotid arteries and a contrast dye is injected. The dye is visible in x-rays then taken of your carotid arteries.
- Computerized tomography (CT Scan) – A CT scan of the brain uses X-ray dye to detect narrowings and blockages. This will reveal any areas of damage.
- Carotid duplex ultrasound – High-frequency sound waves are used to view the neck’s blood vessels and determine any narrowing of the carotid arteries. This procedure is recommended for anyone with heart disease or who is over age 60.
What treatment is available?
- Lifestyle modification – Quit smoking, control high blood pressure and diabetes, exercise regularly, limit your alcohol intake, see your physician regularly and monitor your LDL level, watch your weight and eat a heart-healthy diet.
- Medications – Take aspirin regularly to decrease stroke risk due to blood clots. Sometimes, Coumadin, a blood thinner, may be prescribed.
- Procedures – Carotid stenting is being reviewed by the FDA for treating carotid artery disease. Standard surgical treatment now is a carotid endarterectomy, in which an incision is made in the neck and the carotid artery opened at the point of blockage. The surgeon removes the plaque and damaged parts of the artery and sews it back together. Carotid stenting treatment is available at Mercy’s Katz Cardiovascular Center.
Mercy Outpatient Rehabilitation is also available to help with recovery.
For more information on strokes, click here.
