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Carotid Artery Disease

Overview

Carotid stenosis is narrowing of one or both of the carotid arteries. These arteries take blood from the heart to the brain. There is one on each side of the neck.

A substance called plaque builds up inside an artery. This makes it too narrow. Plaque comes from damage to the artery over time. This damage may be caused by high blood pressure, high cholesterol, diabetes, or smoking. Sometimes plaque can break loose from the carotid artery and move to the brain. This can cause a stroke or transient ischemic attack (TIA).

The goal of treatment is to lower your risk of having a stroke or TIA. You can lower your risk by making healthy lifestyle changes and taking medicine. Sometimes a surgery or procedure is done.

  • Symptoms

    What are the symptoms of carotid artery disease?

    Many people have no symptoms. For some people, a transient ischemic attack (TIA) or stroke is the first sign of the disease.

    If you have any of these symptoms of a TIA or stroke, call 911 or other emergency services right away.

    • Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body.
    • Sudden vision changes.
    • Sudden trouble speaking.
    • Sudden confusion or trouble understanding simple statements.
    • Sudden problems with walking or balance.
    • A sudden, severe headache that is different from past headaches.
  • Causes

    What causes carotid artery disease?

    Plaque can build up in your carotid arteries over time. Plaque may form because:

    • You smoke.
    • You have high blood pressure.
    • You have high cholesterol.
    • You have diabetes.
    • You have a family history of hardening of the arteries
  • Diagnosis

    How is carotid artery disease diagnosed?

    Your doctor may listen to your neck for a sound called a bruit (pronounced "broo-EE"). This whooshing sound is often heard when a carotid artery is narrowed (stenosis).

    If your doctor thinks you may have stenosis, you will have a Doppler ultrasound. This test uses sound waves to show how blood flows through an artery or vein. You also may have a CT angiogram or a magnetic resonance angiogram (MRA).

    Routine tests for carotid artery disease are not recommended for everyone. Experts recommend them only for people who have symptoms.

    Some companies sell ultrasound screening at shopping malls or other places. But insurance doesn't pay for these tests because experts don't recommend them. And since your doctor didn't prescribe the tests, they aren't there to explain the results to you. It's a good idea to talk to your doctor before having one of these tests.

  • Treatment

    How is carotid artery disease treated?

    The goal of treatment is to lower your risk of a transient ischemic attack (TIA) or a stroke. Treatment depends on whether you have symptoms and how much of your arteries are blocked. You probably will take medicine. You also will be encouraged to make healthy lifestyle changes. Some people have procedures to lower their risk.

    Medicines

    You will likely take aspirin or another medicine to prevent blood clots. You will likely also take medicine to lower cholesterol.

    Work with your doctor to manage other health problems, such as high blood pressure and diabetes.

    Avoid colds and flu. Get the flu vaccine every year.

    Lifestyle changes

    Heart-healthy lifestyle changes can help lower your risk of stroke.

    • Quit smoking. Avoid secondhand smoke too.
    • Eat heart-healthy foods.
    • Be active. Ask your doctor what type of exercise is safe for you.
    • Stay at a healthy weight. Lose weight if you need to.

    Regular ultrasounds

    If you have some stenosis-but you don't have symptoms-your doctor may want you to have routine ultrasounds. This is to see if the narrowing in your arteries is getting worse.

    Surgery or stenting

    Surgery in the arteries is called carotid endarterectomy. The doctor makes a cut in the neck and takes the plaque out of the artery.

    Some people have a procedure called stenting. A doctor threads a thin tube through an artery in the groin and up to the carotid artery in the neck. Then he or she uses a tiny balloon to enlarge the narrowed part of the artery and places a stent to keep the artery open.

    Surgery and stenting have a risk of serious problems, such as stroke or heart attack. People who are at increased risk for problems from surgery or stenting include those who have severe heart disease or other serious health problems. You and your doctor can decide together if you should have a procedure.

  • Preventing Stroke

    How are procedures used to prevent stroke?

    Narrowing (stenosis) in a carotid artery increases your risk of stroke. If you have serious blockage in the carotid arteries, you may need a procedure to open the narrowed arteries. Options include:

    Carotid endarterectomy.

    The doctor removes plaque buildup in the carotid arteries.

    Carotid artery stenting.

    This procedure is also called carotid angioplasty and stenting. It's sometimes done instead of surgery. A doctor threads a thin tube called a catheter through an artery in the groin. The catheter is moved up to the carotid artery in your neck. The doctor uses a tiny balloon to enlarge the narrowed portion of the artery. A stent is placed in the artery to keep the artery open.

    The benefits and risks of a procedure must be carefully weighed. The procedure itself may cause a stroke.

  • When to Call

    Carotid stenosis: When to call

    Call 911 anytime you think you may need emergency care. For example, call if:

    • You passed out (lost consciousness).
    • You have symptoms of a stroke. These may include:
      • Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body.
      • Sudden vision changes.
      • Sudden trouble speaking.
      • Sudden confusion or trouble understanding simple statements.
      • Sudden problems with walking or balance.
      • A sudden, severe headache that is different from past headaches.

    Call your doctor now or seek immediate medical care if:

    • You are dizzy or lightheaded, or you feel like you may faint.

    Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.

  • Self-Care

    How can you care for carotid stenosis?

    • Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine. You may take medicine to lower your blood pressure, to lower your cholesterol, or to prevent blood clots.
    • If you take a blood thinner, such as aspirin, be sure to get instructions about how to take your medicine safely. Blood thinners can cause serious bleeding problems.
    • Do not smoke. People who smoke have a higher chance of stroke than those who quit. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
    • Eat a healthy diet that is low in saturated fat and salt. Eat lots of fresh fruits and vegetables and foods high in fiber.
    • Stay at a healthy weight. Lose weight if you need to.
    • Talk to your doctor about starting an exercise program. Regular exercise lowers your chance of stroke.
    • Limit alcohol to 2 drinks a day for men and 1 drink a day for women. Too much alcohol can cause health problems.
    • Work with your doctor to control high blood pressure, high cholesterol, diabetes, and other conditions that increase your chance of a stroke. A healthy diet, exercise, weight loss (if needed), and medicines can help.
    • Avoid colds and flu. Get the flu vaccine every year.

    Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.