Carotid artery disease occurs when the major arteries in your neck become narrowed or blocked. These arteries are those that feed the brain.
The carotid arteries are normally very smooth and blood flows through them easily. When there is a buildup of plaque, a sticky substance that is made up of calcium, cholesterol and tissue, disturbs this flow or can even stop flow completely. As this build up continues the artery be comes hardened. This is called atherosclerosis. Carotid artery disease is a very serious problem that can cause stroke.
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:
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.
What are the symptoms?
Carotid artery disease may not have any symptoms in the beginning. Many times, the first warning of carotid artery disease is a Transient Ischemic Attack or a mini stroke. Symptoms of a mini stroke can last anywhere from a few minutes to an hour. These symptoms include:
These symptoms should not be ignored and you should contact your doctor immediately if they occur.
What testing will be done to diagnose carotid artery disease?
During an exam, a physician may listen to your neck to listen for turbulent flow. If this is present he/she may order a carotid ultrasound. A carotid ultrasound is a non invasive procedure used to assess the arteries that feed the brain. A technician holds a small ultrasound probe to your neck. The probe emits high-frequency sound waves that bounce off of blood cells and blood vessels to show blood flow and problems with the structure of blood vessels. This test can show your physician how open your carotid arteries are and how quickly blood flows through them.
A carotid ultrasound will often give the physician the information he needs regarding the carotid arteries, however, there are other tests that a physician may order to evaluate the carotid circulation. These include:
How is carotid artery disease treated?
Treatment depends on the severity of your condition and whether or not you are having symptoms. If you have any other medical conditions, make sure to follow your physician's instructions to manage them. For example, if you have diabetes, be sure to monitor and control your blood sugar levels. If you have high blood pressure, your physician may prescribe medications to lower it. If you are smoking, you should quit. Have your physician check your cholesterol levels regularly to be sure they stay within normal limits. All of these together can help decrease the progression of the disease. 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.
Angioplasty and stenting is 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 may 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 catheter carries a tiny balloon that inflates and deflates, flattening the plaque against the walls of the artery. Next, the physician places a tiny metal-mesh tube called a stent in the artery to hold it open. Your hospital stay after angioplasty and stenting is approximately the same as with endarterectomy. Carotid angioplasty and stenting is currently controversial because conclusive, long-term results are not yet available. Nevertheless, for patients who have medical conditions that increase the risk of carotid endarterectomy, angioplasty and stenting may be a good alternative. It has been approved for patients considered to be at high risk for the surgical endarterectomy procedure, or for patients who have agreed to participate in ongoing clinical studies designed to determine its effectiveness.