Carotid Artery Disease

Carotid Artery Disease

Your brain is supplied with oxygen-rich blood from two large carotid arteries located on both sides of the neck. These arteries further subdivide into smaller external and internal carotid arteries; the internal arteries supply the brain while the external carotid arteries supply the scalp, face and neck.

In the case of carotid artery disease, also called carotid artery stenosis, these arteries become narrowed and clogged (atherosclerosis) due to waxy plaque build-up which is usually made up of cholesterol and other materials. If a passing blood clot happens to stick in the lumen of these narrowed arteries, blood won’t be able to reach the brain and within a few minutes the brain cells start to die. This is called a ‘stroke’ or a ‘brain attack’ and occurs when blood flow to the brain is cut off resulting in irreparable damage to the brain and long-term disabilities such as paralysis, vision or speech difficulties or even death.

Carotid artery disease doesn’t create any symptoms, but there are tests that can detect its presence and for less severe cases, medicines are available that can prevent blood clots. In severe cases, surgical procedures like carotid angioplasty with stenting and endarterectomy can be performed to remove the plaque from the artery.
The risk for carotid artery disease starts when there is damage to the inner walls of the carotid arteries; the damage induces a healing process which encourages plaque formation at the point of damage. Some of the risk factors contributing to arterial damage are similar to that for heart disease and include smoking, advancing age, high blood pressure, high cholesterol and lipid levels, diabetes, obesity, sedentary life-style and a family history of coronary artery disease or carotid artery disease.

Since the disease is usually symptom-free, it is all the more dangerous. Without warning, the plaque in an artery can rupture, leading to clump formation by circulating blood platelets and a blockage of blood flow to the brain, or a stroke.

Signs of a stroke can produce a myriad of sudden-onset symptoms which include dizziness, confusion, difficulty in speech, difficulty in swallowing, loss of coordinated walking and loss of balance, blurry vision or vision difficulties in one or both eyes, severe headache and memory problems.

Diagnosis involves listening to the artery with a stethoscope for abnormal blood flow sounds followed by tests like CT angiography, MRA, cerebral angiography or carotid ultrasound.

Effective treatment includes a change in lifestyle habits, medications such as anti-platelet s or blood-thinners as well as surgical procedures.

Treatment procedures include carotid endarterectomy where the artery with the block is accessed from the side of the neck and the plaque and diseased part removed; a newer procedure is carotid artery stenting executed by a narrow catheter threaded into the diseased artery and a stent placed at the point of artery narrowing to open it up.

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