Carotid artery disease

Located in your neck, your two carotid arteries are the main vessels that supply blood to the brain and heart. Carotid artery disease is the result of atherosclerosis — the buildup of plaque (fatty substances, calcium and waste) in the lining of those arteries. This buildup narrows the passageway inside the arteries, restricting blood flow.

With an inadequate supply of blood to the heart, it can't function properly and becomes damaged and dysfunctional. This damage increases the risk of stroke and heart attack.

Carotid artery disease is similar to coronary artery disease, which results when plaque builds up in the arteries in the heart. Carotid artery disease tends to develop a few years after coronary artery disease has set in.

Risk factors for carotid artery disease

The risk factors for carotid artery disease include a mix of genetic and lifestyle factors, including:

• Advancing age.
• Family history.
• Hypertension (high blood pressure).
• Diabetes.
• High cholesterol.
• Smoking/tobacco use.
• Obesity.
• Sedentary lifestyle.
• Sleep apnea.

Symptoms of carotid artery disease

Carotid artery disease develops slowly over time. Symptoms are subtle and generally go unnoticed until the artery becomes nearly or fully blocked. However, warning signs that point to possible blockage in the carotid arteries include stroke-like symptoms such as:

• Numbness.
• Tingling.
• Inability to speak correctly.
• Garbled words.
• Vision problems.
• Headaches.
• Dizziness.
• Fainting.

In many cases, carotid artery disease isn't detected until you experiences a transient ischemic attack (TIA), one of several types of stroke often referred to as a mini-stroke.

Diagnosing carotid artery disease

Diagnosing carotid artery disease begins with a comprehensive medical examination, blood tests and other diagnostic tests such as imaging tests that may provide real-time and/or 3D views of the carotid arteries to determine how the blood is flowing and if there's a blockage.

Imaging tests most commonly used to diagnose carotid artery disease include:

• Ultrasound.
• Angiography.
• MRI.
• CT scan.

Treating carotid artery disease

Treatment for carotid artery disease begins with making lifestyle changes to reduce the risk of stroke, heart attack and more. This includes adopting a healthy diet, exercising and quitting use of tobacco products. Depending on risk factors, severity of the condition and whether a stroke has already occurred, medical treatment may be needed, including:

• Medication to manage blood pressure, lower cholesterol and/or prevent blood clotting.
• Procedures to remove the blockage such as:
  • Carotid stenting, a type of minimally invasive surgery in which a specialist inflates or widens the artery. This provides more room in the artery through which blood can flow.
  • Carotid endarterectomy in which the surgeon opens the carotid artery and removes the plaque.