Carotid Artery Disease
Narrowing of the carotid arteries is called as carotid artery disease. This condition is the third leading cause of death in the U.S. This article will discuss information that will help you learn more about carotid artery disease.
What are Carotid Arteries?
Carotid arteries carry oxygen-rich blood from the heart to the brain and face. There are two common carotid arteries, that are present on either side of the neck. One can feel the pulse in the carotid arteries on either side of the neck.
These arteries divide into internal and external carotid arteries. The external arteries supply blood to the neck, face and scalp. The internal arteries supply blood to the brain. They supply blood to that region of the brain where thinking, speech, personality and sensory as well as motor functions are carried out.
What is Carotid Artery Disease?
Also, called as carotid artery stenosis, it refers to the narrowing of the carotid artery. This occurs due to atherosclerosis, that is, hardening of the arteries on the inside. Atherosclerosis can affect any artery within the body. The plaque, that is, fatty substances as well as cholesterol builds up over the years blocks the carotid artery. This decreases the blood flow to the brain, increasing the chances of stroke.
The plaque build or a blood clot can break free from the wall of the carotid artery. It can travel to the brain through the bloodstream. This plaque or clot can stop anywhere within the brain and lead to a stroke by blocking the blood flow.
This stroke is similar to a heart attack. The lack of blood flow to the brain causes it to shut down the affected part. If the lack of blood flow continues for more than 3 to 6 hours, it could lead to permanent damage.
Carotid artery disease develops slowly and gradually. Thus, it often goes unnoticed, until one suffers from a stroke or transient ischemic attack (TIA).
There are no obvious symptoms of carotid artery disease, until it disrupts the blood flow within the brain. The symptoms that appear are usually when the hardened artery ruptures or a piece of plaque or a blood clot blocks the blood supply to certain area of the brain. Such symptoms include:
- Sudden blurring or dimming of vision in one or both eyes
- Blindness in one or both eyes
- Weakness, tingling and numbness on one side of the face or body or an arm or leg
- Problems speaking or understanding words
- Unsteady gait or falling down
- Balancing problems
- Problems with coordination
- Nausea and vomiting
- Loss of consciousness
- Sudden confusion
- Loss of memory
- Problems swallowing
- Sudden, severe headache
The signs and symptoms may last for an hour or maybe for a longer period. After experiencing these symptoms one may become normal again. You need to visit the doctor right away, as you may have just experienced a ministroke or TIA. Ignoring these symptoms increases your risk of full blown stroke and complications such as permanent paralysis, blindness as well as death.
The most common cause of carotid artery disease is atherosclerosis. It is a slow, progressive and vascular disease. The disease may make an appearance as early as in childhood. The fatty deposits accumulate within the artery for over years. As the disease progresses, the fatty deposits form plaque that consists of smooth muscle cells, fatty substances, cholesterol, calcium as well as other cellular waste. This build up causes the artery wall to harden and become narrow on the inside. Complete or partial blockage decreases the blood supply to the brain, leading to a stroke.
There are certain risk factors that increase one’s chances of suffering from carotid artery disease and stroke. These risk factors include:
- Family history of atherosclerosis
- Age, that is, men aged75 and younger and women aged 75 and older
- High blood pressure
- High cholesterol levels
- History of coronary artery disease
- History of Peripheral artery disease (PAD)
What are the Tests Done to Determine Carotid Artery Disease?
The doctor will take your medical history and ask you about the symptoms. A physical examination will be carried out followed by the hearing of the sounds of irregular blood flow in the carotid arteries with the help of a stethoscope.
Other tests may be carried out that includes:
- Doppler ultrasound imaging
- Oculoplethysmography (OPG)
- Computed tomography (CT) Scan
- Arteriography and Digital Subtraction Angiography (DSA)
- Magnetic Resonance Angiography (MRA)
- Magnetic resonance imaging (MRI)
- Cerebral angiogram
How is Carotid Artery Disease Treated?
Carotid artery disease is treated by making changes in lifestyle, taking prescribed medications as well as undergoing procedures recommended by the doctor.
The medications prescribed for carotid artery disease include anti-platelet medications such as aspirin, clopidogrel, Dipyridamole, tissue plasminogen activator (t-PA).
The procedure for treating narrowing of carotid artery is carotid endarterectomy. This is the traditional treatment wherein an incision is made in the neck at the site of carotid artery blockage under general or local anesthesia. The plaque is removed from the artery and the vessel is closed. Soon, the blood flow to the brain is restored through its normal path.
Carotid angioplasty and stenting is another procedure that is performed under sedation. A balloon catheter is inserted in a blood vessel and guided to the blocked carotid artery. The balloon is inflated and a special mesh or guidewire with filter is placed in the area of blockage or narrowing. The inflated balloon widens the artery and the filter collects any debris that breaks off from the blockage. A stent is placed in the artery permanently to support and keep the artery wall open.
The lifestyle changes recommended include:
- Eating a healthy diet
- Exercising regularly
- Quit smoking and using other tobacco products
- Undergoing regular health check ups
- Reducing weight
- Limiting the daily alcohol intake
Carotid artery disease is the third highest cause of death as well as paralysis in the Industrialized world. One should visit their doctor regularly to make sure the condition remains in control and the treatment given has a positive effect on your health. One has the best chance to recover fully if the blocked artery is opened within 4 hours of the appearance of symptoms. Thus, the minute one experiences any symptoms similar to a stroke, visit the doctor right away. It can help lower your chances of permanent disability as well as death.
Written by: Saptakee sengupta
Date last updated: March 29, 2015