Carotid Stenosis

Overview

Carotid Stenosis is a narrowing or constriction of any part of the carotid arteries, usually caused by atherosclerosis.  Carotid Stenosis occurs when fatty deposits (plaques) clog the blood vessels that deliver blood to your brain and head (carotid arteries). The blockage increases your risk of stroke, a medical emergency that occurs when the blood supply to the brain is interrupted or seriously reduced.  

Symptoms & Complications

In its early stages, carotid artery disease often doesn't produce any signs or symptoms. The condition may go unnoticed until it's serious enough to deprive your brain of blood, causing a stroke or TIA.

Signs and symptoms of a stroke or TIA include:

  • Sudden numbness or weakness in the face or limbs, often on only one side of the body
  • Sudden trouble speaking and understanding
  • Sudden trouble seeing in one or both eyes
  • Sudden dizziness or loss of balance
  • Sudden, severe headache with no known cause

Causes & Risk Factors

Causes include:

 

Carotid artery disease is caused by a buildup of plaques in arteries that deliver blood to your brain. Plaques are clumps of cholesterol, calcium, fibrous tissue and other cellular debris that gather at microscopic injury sites within the artery. This process is called atherosclerosis.

Carotid arteries that are clogged with plaques are stiff and narrow. Clogged carotid arteries have trouble delivering oxygen and nutrients to vital brain structures that are responsible for your day-to-day functioning.


 

Risk include:


  • High blood pressure. Excess pressure on artery walls can weaken them and make them more vulnerable to damage.
  • Tobacco use. Nicotine can irritate the inner lining of your arteries. Smoking also increases your heart rate and blood pressure.
  • Diabetes. Diabetes lowers your ability to process fats efficiently, placing you at greater risk of high blood pressure and atherosclerosis.
  • High blood-fat levels. High levels of low-density lipoprotein cholesterol and high levels of triglycerides, a blood fat, encourage the accumulation of plaques.
  • Family history. Your risk of carotid artery disease is higher if a relative has atherosclerosis or coronary artery disease.
  • Age. Arteries become less flexible and more prone to injury with age.
  • Obesity. Excess weight increases your chances of high blood pressure, atherosclerosis and diabetes.
  • Sleep apnea. Spells of stopping breathing at night may increase your risk of stroke.
  • Lack of exercise. It contributes to conditions that damage your arteries, including high blood pressure, diabetes and obesity.

Carotid Stenosis Treatment

At SVS you will be treated by fully trained vascular surgeons

The goal in treating carotid stenosis is to prevent a stroke. Specific treatments depend on the extent of blockage in your carotid arteries.


If blockage is mild to moderate, your doctor may recommend:


  • Lifestyle changes to slow the progression of atherosclerosis. Recommendations may include quitting smoking, losing weight, eating healthy foods, reducing salt and exercising regularly.


  • Medication to control blood pressure or lower cholesterol. Your doctor may also recommend taking a daily aspirin or other blood-thinning medication to prevent blood clots.

If blockage is severe, or if you've already had a TIA or stroke, your doctor may recommend removing the blockage from the artery. The options include:


  • Carotid endarterectomy, the most common treatment for severe carotid artery disease. After making an incision along the front of your neck, the surgeon opens the affected carotid artery and removes the plaques. The artery is repaired with either stitches or a graft.


  • Carotid angioplasty and stenting, if the blockage is too difficult to reach with carotid endarterectomy or you have other health conditions that make surgery too risky. 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 a small wire mesh coil (stent) is inserted to keep the artery from narrowing again.

What to do next?

Seek emergency care if you experience any signs or symptoms of stroke. Even if they last only a short while and then you feel normal, see a doctor right away. You may have experienced a TIA, an important sign that you're at risk of a full-blown stroke.  Seeing a doctor early increases your chances that carotid artery disease will be found and treated before a disabling stroke occurs.