Carotid Artery Disease
What is carotid artery disease?
It is when the carotid arteries in the neck become narrowed or blocked. These arteries supply your brain with blood. Your carotid arteries extend from the aorta in the chest to the brain inside the skull.
Carotid artery disease is more common on older people, and the chances of developing it, increase with age. About 1 percent of adults age 50 to 59 have significantly narrowed carotid arteries, but 10 percent of adults age 80 to 89 have this problem.
The arteries are normally smooth and unobstructed, but as we age, a sticky substance called plaque can build up in the walls of the arteries. Plaque is made up of cholesterol, calcium, and fibrous tissue. As more plaque builds up, the arteries narrow and stiffen. This process is called atherosclerosis, or hardening of the arteries. Eventually, when enough plaque builds up to reduce the blood flow through the carotid arteries, physicians call this problem carotid artery disease. Carotid artery disease is a serious health problem because it can cause a stroke.
Some plaque deposits are soft and are prone to cracking or forming roughened, irregular areas inside the artery. If this happens, the body will respond as if you were injured and flood the cracked and irregular areas with blood-clotting cells called platelets. A large blood clot may then form in the carotid artery or one of its branches. If the clot blocks the artery enough to slow or stop blood and oxygen flow to your brain, it could cause a stroke.
More commonly, a piece of the plaque itself, or a clot, breaks off from the plaque deposit and travels through your bloodstream. This particle can then lodge in a smaller artery in your brain and cause a stroke by blocking the artery.
Fortunately, you may be able to prevent or slow carotid artery disease. Quitting smoking is the most important change you can make to avoid this disease. Other ways to prevent carotid artery disease include:
- Exercising regularly.
- Eating a healthy diet.
- Maintaining a healthy weight.
Controlling factors that increase your chances of developing carotid artery disease, such as diabetes, high blood pressure, or high cholesterol, also help prevent the disease.
The symptoms
Usually, the first sign of carotid artery disease could be a stroke. However, you may experience warning symptoms of a stroke called transient ischemic attacks, or TIAs. Symptoms of a TIA usually last for a few minutes to 1 hour and include:
- Feeling weakness, numbness, or a tingling sensation on one side of your body, for example, in an arm or a leg.
- Being unable to control the movement of an arm or a leg.
- Losing vision in one eye.
- Being unable to speak clearly.
These symptoms usually go away completely within 24 hours. However, you should not ignore them. Having a TIA means that you are at serious risk of a stroke in the near future. You should report TIA symptoms to your physician immediately. If you experience the above symptoms for longer than a few hours, or they don’t resolve within 24 hours, a stroke has probably occurred. You should contact your physician immediately.
What causes carotid artery disease?
Hardening of the arteries causes most cases of carotid artery disease. Factors that injure artery walls include smoking, high cholesterol, and high blood pressure. Other factors that may increase your chances of developing carotid artery disease include diabetes and having a family history of hardening of the arteries.
How can it be detected?With a CT scan and CT Angiography (CTA): CT and CTA scans take x-ray pictures in the form of slices of the brain and the arteries in your neck. CT scans can show an area of the brain that has poor blood flow. Your physician may inject a contrast dye to make blood vessels visible on the x-ray image. CTA shows the arteries in the neck and head and will identify areas of arterial narrowing. At Centro Médico Excel, we have a sophisticated 64-slice CT scanner.
Treatment
Your treatment will depend on the severity of your condition, and whether or not you are having symptoms from the carotid artery disease, as well as your general health. As a first step, your vascular surgeon may recommend medications and the lifestyle changes.
You may require surgery if your carotid artery disease is severe or has progressed. Signs of severe disease include having TIA symptoms, having experienced a stroke in the past, or just having a severely narrowed carotid artery even without symptoms.
A newly developed minimally invasive procedure to treat carotid artery disease is angioplasty and stenting. Angioplasty and stenting is usually performed using a local anesthetic. To perform this procedure, your vascular surgeon will insert a long, thin tube called a catheter through a small puncture site over a groin artery and guide it through your blood vessels to your carotid artery. The surgeon then inserts another catheter that carries a tiny balloon that inflates and deflates, flattening the plaque against the walls of the artery. The physician will then place a tiny metal-mesh tube called a stent in the artery to hold it open. This procedure has been approved for patients considered to be at high risk for the surgical endarterectomy procedure.
