Carotid Artery Disease

Carotid artery disease occurs when plaque builds up in the carotid arteries—two major blood vessels in the neck that supply blood to the brain. This buildup, called atherosclerosis, narrows the arteries and limits blood flow, increasing the risk of stroke. Most strokes linked to this condition happen when a piece of plaque or a blood clot blocks blood flow to the brain.

The disease is typically classified by how much the artery is narrowed:

• Mild (Less than 50%) – Often managed with medication and lifestyle changes.
• Moderate (50–69%) – Monitoring and medical management is recommended.
• Severe (70% or more) – May require intervention to restore blood flow.

The main cause of carotid artery disease is atherosclerosis, a gradual buildup of cholesterol, fat, calcium, and other substances in the artery walls. Risk factors include:

• Older Age
• Smoking
• High blood pressure
• High cholesterol
• Diabetes
• Obesity
• Lack of exercise
• Family history of cardiovascular disease

Carotid artery disease often has no symptoms until a stroke or transient ischemic attack (TIA) occurs. Warning signs may include:

• Sudden weakness or numbness in the face or limbs (especially on one side)
• Trouble speaking or understanding speech
• Loss of vision in one eye
• Dizziness or loss of balance
• Sudden severe headache

These symptoms are medical emergencies. Call 911 immediately.

Diagnosis involves imaging tests to assess narrowing and plaque buildup:

• Carotid Ultrasound – First-line test that visualizes blood flow.
• CT Angiography (CTA) – Provides detailed images of carotid arteries.
• Magnetic Resonance Angiography (MRA) – Noninvasive imaging that provides detailed images of the carotid arteries.
• Carotid Angiogram – Invasive test used in select cases for detailed evaluation, sometimes used before surgical intervention.

Treatment depends on the severity of the blockage and overall health:

• Lifestyle Modifications – Quit smoking, eat healthy, exercise regularly, and manage cholesterol and blood pressure.
• Medications – Antiplatelets, statins, and blood pressure drugs may be needed.
• Carotid Endarterectomy (CEA) – Surgical removal of plaque from the artery, typically reserved for patients with significant narrowing (usually >70%).
• Carotid Artery Stenting (CAS) – Less invasive procedure that uses a stent to keep the artery open, often used in high-risk surgical patients.
• Stroke Rehabilitation – For patients who have experienced a TIA or stroke.

If untreated, carotid artery disease can lead to:

• Ischemic Stroke
• Transient Ischemic Attack (TIA)
• Permanent disability from stroke
• Cognitive decline from reduced brain perfusion

Prevention focuses on heart-healthy habits:

• Avoid tobacco
• Eat a balanced diet low in saturated fats
• Exercise regularly
• Control diabetes and high blood pressure
• Get regular checkups if you have risk factors