Carotid Artery Disease

WHAT IS CAROTID ARTERY DISEASE?

Carotid artery disease is a condition where abnormal deposits (plaques) build up on the interior walls of the blood vessels that deliver blood to your brain and head. Those blood vessels are known as the carotid arteries. Carotid artery disease usually develops slowly over time.

CAROTID ARTERY DISEASE AND STROKE

When the carotid arteries get blocked it significantly increases the risk of stroke. With a stroke, the blood flow to the brain is reduced to a dangerous level. Stroke robs the brain of oxygen, and it only takes minutes for brain cells to die off. Stroke is the most common cause of mortality and the leading cause of permanent disability in the U.S.

As large plaques rupture, the ulcerated surface of the plaque becomes the perfect breeding ground for blood clots. These clots, known as emboli, can become dislodged and enter the blood stream going to the brain. Once in the brain, the clot travels to ever smaller vessels until it eventually lodges in one, cutting off blood flow to the brain from that point on. Smaller clots will lodge in smaller arteries, causing less damage or even transient ischemic attack (TIA). Larger clots will lodge in larger arteries, causing even more damage to the brain.

The first sign that you have carotid artery disease unfortunately could be having a stroke or a TIA. The difference between a TIA and a stroke, is that TIA symptoms are typically not permanent and resolve within 24 hours. TIA symptoms are a very serious warning that a stroke may occur or could be imminent. Stroke symptoms are because the affected brain tissue has actually died and are longer lasting and in some cases unfortunately permanent.

SYMPTOMS & RISK FACTORS OF STROKE

It is important to note is that carotid artery disease may present no symptoms at all until the patient has a TIA or a stroke. Often times carotid artery disease is only diagnosed after a stroke occurs.

Symptoms associated with stroke may include:

Numbness or weakness in the face or limbs, often on only one side of the body
One-sided facial drooping
Slurred speech, or trouble talking or comprehending speech
Difficulty seeing in one or both eyes
In the case of TIA, you could experience what appears to be a shade coming down over one eye, which eventually lifts (amorosis fugax)
Sudden dizziness or lack of balance
Onset of severe headaches with no readily identifiable triggers
Ringing in the ears or fainting (rare)

Some common risk factors associated with stroke include:

Smoking or nicotine use
Diabetes
Obesity or overweight
High blood pressure and high cholesterol
Poor dietary habits
Lack of exercise or sedentary lifestyle
Family history of atherosclerosis or coronary artery disease
Advanced age

DIAGNOSING CAROTID ARTERY DISEASE

In the case of carotid artery disease, it is absolutely critical that you be evaluated and diagnosed specifically by a vascular surgeon or vascular specialist with experience in carotid artery disease.

Vascular screening ultrasounds – while not a diagnostic tool per se screening ultrasounds can be important for evaluating presence of plaque and prompting more complete evaluation in selected patients
Physical evaluation by a vascular surgeon
Duplex ultrasound
Imaging tests – CTA, MRA, Angiogram

TREATING CAROTID ARTERY DISEASE

Medications, including antiplatelet agents (such as aspirin and/or clopidogrel) and statins (anti cholesterol medications)

Smoking cessation

Surgery such as carotid endarterectomy (CEA) -or- in selected cases carotid angioplasty and/stenting (CAS)

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WHAT IS CAROTID ARTERY DISEASE?