Carotid Arterial Disease
The carotid arteries, located in the neck, are the main source of blood supply to your brain.
As we age, plaque accumulates inside the arteries. If too much builds up in the carotid artery it can cause the artery to narrow (carotid stenosis). Small clots can form, then break off and travel to the brain, causing a stroke. Carotid stenosis is responsible for up to one-third of all strokes—and strokes cause 1 of every 15 deaths in the U.S.
As many as 3% of people over age 65 have carotid artery disease. Your risk increases as you age, and is greater if you have a history of smoking, high blood pressure, high cholesterol, diabetes or heart disease.
Many people with carotid artery disease (CAD) experience no symptoms, even if the blockage is severe. The condition is sometimes found during a routine physical or eye exam, or following a stroke. In rare cases, CAD may cause fainting or ringing in the ears due to decreased blood flow to the brain. Because the first signs of carotid artery disease may be a stroke or mini-stroke, it’s important to know those symptoms:
Weakness or numbness on one side of the body
If you experience the symptoms of a stroke, seek immediate medical help.
During a routine physical exam, your doctor listens to certain blood vessels using a stethoscope. If a whistling sound is heard, it could indicate plaque build-up in the carotid artery.
CAD may also be detected during an eye exam if your doctor sees plaque in the artery that supplies the retina. In either case, you’ll be referred to a vascular surgeon for treatment.
The surgeon will most likely suggest a carotid artery duplex scan, a non-invasive test that is done using two kinds of ultrasound. This helps determine if the carotid artery is narrowing and provide an accurate estimate of the severity.
Occasionally the surgeon may recommend alternative tests such as a CT scan, MRI or an angiogram.
The purpose of treating carotid artery disease is to reduce the possibility, or the recurrence, of a stroke. The specific treatment will depend on the degree of artery blockage.
Medications can help slow the progress of carotid artery disease. If the degree of narrowing is less than 50-60%, aspirin, and medication that lower cholesterol and blood pressure are often prescribed.
If the narrowing is greater than 60% of the artery, surgery may be recommended in addition to medication. Common procedures are carotid endarterectomy or carotid angioplasty and stenting.