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What is Carotid Artery Disease?

Carotid artery disease occurs when one or both of the carotid arteries are narrowed or blocked with a waxy substance called plaque. When the body is functioning optimally, the carotid arteries carry oxygenated blood to the head and brain. There are two carotid arteries — one on either side of the neck — and those arteries are made up of both internal and external arteries. The internal arteries take oxygenated blood to the brain, while the external arteries move oxygen-rich blood to the neck, face and scalp.

However, aging and a number of other factors can cause plaque to build up in those arteries, cutting off that essential blood flow. Plaque is made up of cholesterol, fat, calcium and other substances that can accumulate and cause the arteries to narrow, a condition known as carotid stenosis.

Blocked carotid arteries can have serious complications. In fact, carotid artery disease is a significant cause of stroke among Americans. Stroke can also occur if a blood clot forms within the carotid arteries, which can happen if plaque buildup cracks or ruptures.

Carotid Artery Disease Symptoms

In many cases, someone who has carotid artery disease may have no noticeable symptoms. However, as the blockage worsens, symptoms may result. Symptoms related to carotid artery disease include:

  • Bruit, which is a whooshing sound from the carotid arteries heard through a stethoscope
  • Stroke, which is a severe medical condition that requires immediate medical attention to limit its effects on the brain
  • Transient ischemic attack, also called a ministroke, which can cause many stroke-like symptoms, such as dizziness, difficulty seeing or weakness on one side of the body

How Carotid Artery Disease Is Diagnosed

If symptoms of carotid artery disease are exhibited or if a ministroke or stroke has been experienced, a doctor will confirm a diagnosis by reviewing symptoms, considering personal and family medical history, and conducting a physical exam. To make a definitive diagnosis, testing will be ordered, including:

  • Carotid ultrasound
  • Carotid angiography
  • Magnetic resonance angiography
  • CT angiography

Carotid Artery Disease Treatment

Treatment for carotid artery disease will vary depending on a person’s individual needs and medical history. In less severe cases where blockage is minor, a doctor may recommend making lifestyle changes. These changes may include eating a heart-healthy diet with fruits and vegetables, getting to and maintaining a healthy weight, finding healthy ways to manage stress, getting regular physical activity and quitting smoking. In other cases, a doctor may prescribe medications to prevent blood clots or manage other contributing medical conditions, such as diabetes and high cholesterol.

If the carotid artery has narrowed due to carotid stenosis, a medical procedure called carotid endarterectomy may be recommended. This procedure is typically used in cases where the carotid arteries are at least 50% blocked. During the procedure, an incision is made into the carotid artery and the part of the arterial lining blocking blood flow is removed.

Another treatment option involves a procedure called carotid artery angioplasty, where arteries are widened to restore blood flow. During an angioplasty, a thin tube with a deflated balloon at its end is threaded through a blood vessel to the carotid artery. The balloon is then inflated to push the plaque back against the artery wall and a stent is put inside to support the artery wall.

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