Carotid artery disease
What is carotid artery disease?
Carotid artery disease occurs when there is damage to the inner layers of the arteries, which supply blood to the brain. Approximately 30 percent of strokes are caused by narrowing or blockages in the carotid arteries on either side of the neck.
Symptoms depend on the location of the blocked brain blood vessel. Because you may not have symptoms, you may not even know you have carotid artery blockage until it interrupts blood flow to the brain. When the brain is deprived of blood, it stops functioning and a stroke occurs.
If you or someone you know is experiencing symptoms of a stroke, you should call 911 immediately. A stroke can cause brain damage within minutes. With quick treatment, it is possible to minimize a stroke's effects. Stroke symptoms may include:
- Partial loss of vision in one eye, double vision, uncontrollable eye movements or eye drooping
- Weakness, tingling or numbness in one arm and/or leg
- Temporary loss of control of movement in one arm and/or leg
- Inability to pronounce words or speak clearly
- Numbness on one side of the face
- Unsteadiness, vertigo, loss of balance or sudden falls
- Difficulty swallowing
- Temporary memory loss
- Personality or mood changes
- Drowsiness or loss of consciousness
When arteries are damaged, the natural healing process may help build up plaque or cholesterol deposits, which can crack or rupture. When this occurs, platelets (blood cell fragments) stick to the injury site and may form blood clots. Plaque or blood clots can severely narrow or block the carotid arteries, interrupting blood flow to the brain, and a stroke can occur.
A stroke caused by a blockage is called ischemic (the most common type, more than 90 percent of cases); one caused by bleeding in the brain is called hemorrhagic. Sometimes atrial fibrillation (“A-fib”) can cause stroke. When the blood supply to a part of the brain is stopped, brain damage can occur in minutes. Sometimes a "mini stroke," or transient ischemic attack (TIA), occurs instead; in this case, stroke-like symptoms occur, but there may be no lasting damage.
Some factors contributing to carotid artery disease are:
- High levels of certain fats and cholesterol in the blood
- High blood pressure
- High levels of sugar in the blood due to insulin resistance or diabetes
You are at risk for carotid artery disease if you:
- Are obese
- Are diabetic
- Eat fatty foods
- Have high cholesterol or blood pressure
- Do not get much exercise or lead a sedentary lifestyle
- Have a family history of heart disease
- Have excess stress
- Have already had a TIA or small stroke, you are at high risk for a permanent stroke
Minimally invasive and traditional treatment options are available for carotid artery disease. Specialists from vascular and endovascular surgery, cardiology, interventional cardiology, neurosurgery, neuroradiology and interventional imaging work together using the most advanced medical technologies available. Treatments include:
- Angioplasty and stenting – In this minimally invasive procedure, a surgeon guides a balloon-tipped tube (catheter) through arteries until it reaches the area in the carotid artery that is blocked with plaque. The surgeon inflates the balloon, which compresses the plaque and widens the artery. A stent (a small metal-mesh tube) is then inserted through the catheter to prop open the carotid artery.
- Carotid endarterectomy – A surgeon creates a small incision in the carotid artery and strips the carotid artery of the plaque causing the blockage or narrowing.
- Intracranial stenting – A neurointerventionalist places a stent in a narrowed artery in your brain to help increase blood flow. In a procedure similar to angioplasty, a tiny balloon is inserted through a catheter into the brain and inflated to widen the narrowed artery, then a stent is placed in the brain to hold open the artery.
- Intracranial coiling – Coiling is used to treat brain aneurysms that have ruptured, leading to a hemorrhagic stroke. To perform coiling, your neurointerventionalist inserts a catheter, usually through your groin, and threads it through your body to the area of the aneurysm. A wire coil is inserted through the catheter and threaded into the aneurysm. The coil fills up the aneurysm and disrupts the blood flow to the aneurysm.
Because the effects of stroke can be devastating, prevention is essential. Though you cannot control factors such as age and gender, a healthy lifestyle goes far in preventing carotid artery disease. Lifestyle changes such as the following can reduce your risk of having a stroke:
- Exercising more
- Losing excess weight
- Quitting smoking
- Eating a diet rich in fresh fruits and vegetables, whole grains and lean proteins
- Limiting alcohol to no more than one drink per day for women and two per day for men
- Scheduling regular physical exams