What is carotid stenosis?
The carotid arteries are the large blood vessels in the neck that carry blood to the brain. They are located on both sides of the neck.
Carotid stenosis is a condition in which these arteries become narrowed or blocked. Stenosis occurs when a sticky, fatty substance (plaque) builds up in the inner lining of the arteries. The plaque may slowly block the artery, or cause a clot to form. These clots can lead to a stroke.
Carotid stenosis is a condition in which these arteries become narrowed or blocked. Stenosis occurs when a sticky, fatty substance (plaque) builds up in the inner lining of the arteries. The plaque may slowly block the artery, or cause a clot to form. These clots can lead to a stroke.
What are risk factors for carotid stenosis?
- Smoking
- High blood pressure
- High cholesterol
- Diabetes
- Family history
- Heart or other vascular disease
What are symptoms of carotid stenosis?
Not all patients with carotid stenosis have symptoms. Some have symptoms of a stroke or TIA (transient ischemic attack or “mini-stroke”). These symptoms may include
- Weakness or numbness on one side of the face or body
- Difficulty with speech or understanding
- Difficulty swallowing
- Loss of balance or coordination
- Sudden loss of vision, blurred vision or difficulty seeing out of one eye
- Confusion
How is carotid stenosis diagnosed?
- History and physical examination
- Carotid ultrasound
- MRA or CTA
- Catheter angiography
How is carotid stenosis treated?
Treatment options are determined by symptoms, the location and degree of stenosis, age and medical history. There are several ways in which carotid stenosis is treated.
Carotid angioplasty and stenting – This procedure treats the stenosis from inside the blood vessels and usually involves accessing the large artery in the groin via a small skin nick, and tracking a catheter, or small plastic tube, from the groin to the carotid artery. From there, a balloon is inflated, opening up the artery (angioplasty). A stent may be deployed, allowing the artery to remain open. This procedure is performed by an interventional neuroradiologist.
Carotid endarterectomy – Under anesthesia, an incision is made in the neck at the site of blockage. The carotid artery is clamped, opened and the plaque is surgically removed. The artery is then sewn back together, allowing improved blood flow. This procedure is performed by a vascular surgeon.
Medical therapy – Medications such as aspirin and clopidogrel (Plavix) interfere with the formation of blood clots. Other medications for blood pressure, cholesterol or diabetes may be considered. Lifestyle changes such as exercise, healthy eating and not smoking are always recommended.
Carotid angioplasty and stenting – This procedure treats the stenosis from inside the blood vessels and usually involves accessing the large artery in the groin via a small skin nick, and tracking a catheter, or small plastic tube, from the groin to the carotid artery. From there, a balloon is inflated, opening up the artery (angioplasty). A stent may be deployed, allowing the artery to remain open. This procedure is performed by an interventional neuroradiologist.
Carotid endarterectomy – Under anesthesia, an incision is made in the neck at the site of blockage. The carotid artery is clamped, opened and the plaque is surgically removed. The artery is then sewn back together, allowing improved blood flow. This procedure is performed by a vascular surgeon.
Medical therapy – Medications such as aspirin and clopidogrel (Plavix) interfere with the formation of blood clots. Other medications for blood pressure, cholesterol or diabetes may be considered. Lifestyle changes such as exercise, healthy eating and not smoking are always recommended.
