Carotid artery disease

According to the Centers for Disease Control and Prevention (CDC), approximately 15 million individuals are diagnosed with stroke every year. And, about six million people die due to stroke. Untreated carotid artery disease or atrial fibrillation may lead to stroke.

You have two common carotid arteries located on the side of your neck; the internal carotid artery which supplies oxygen-rich blood to your brain and external carotid artery which supplies oxygen rich blood to your face, neck and scalp. You can feel the carotid artery pulse below the angle of the jawline. Carotid artery disease, also called as carotid stenosis is the blockage of the arteries that carry oxygenated blood and glucose to your brain. The blockage is mainly due to the build-up of plaques in the blood vessels.

A progressive narrowing of the carotid arteries due to the formation of the plaque causes carotid artery disease. The plaque is the composition of fat, cholesterol, calcium, and fibrous materials in the luminal walls of your carotid artery. The buildup of plaque in the arteries is called as carotid atherosclerosis. These blocked carotid arteries fail to deliver adequate oxygenated blood and glucose to the brain leading to life-threatening complications such as stroke.

A minor blockage may not cause any symptoms. The carotid artery blockage symptoms are noticed when the condition is severe, leading to stroke. The symptoms of stroke include the following:

  • Sudden numbness in the face or limbs (Usually only one side of the body)
  • Sudden trouble speaking or understanding
  • Sudden vision problems
  • Dizziness or loss of balance
  • Sudden, severe headache
  • Drooping on one side of your face

Several underlying medical conditions may increase the possibility of carotid artery disease and stroke, which includes;

  • High blood pressure
  • High cholesterol
  • Diabetes
  • Physical inactivity
  • Obesity
  • Smoking
  • Increasing age
  • Family history of atherosclerosis

If carotid artery disease is left untreated, it can lead to fatal complications such as stroke or transient ischaemic attack (TIA).

Carotid artery disease causes stroke through the following ways:

Decreased blood flow: The plaque formation may result in narrowing of the carotid artery. Thus causing reduced blood flow to the brain.

Ruptured plaques: Sometimes, a lump of plaque is broken into pieces. The plaque fragments then travel through the smaller artery into the brain and blocks them. This leads to blockage of blood supply to a part of the brain.

Blood clot blockage: The plaques can form irregular surfaces on the artery wall. Your body responds to this by sending blood cells near the plaque as a defense mechanism. This results in the formation of blood clot that slows blood flow to the brain leading to stroke.

The diagnosis begins with a medical history and physical examination. Your doctor may recommend any of the following tests to rule the conditions.

  • Ultrasound scan: The ultrasound scan is used to assess the flow and pressure of the blood in the carotid arteries.
  • Computed tomography (CT) scan or magnetic resonance imaging (MRI): The CT or MRI is used to evaluate the evidence of stroke or any other medical condition.
  • CT angiography: The CT angiography is performed to obtain detailed images of the blood flow in the carotid arteries.

If you’re diagnosed with coronary artery disease, you may receive an aggressive treatment to stop further blockage. The primary goal of the treatment plan is to reduce the risk of stroke. Your doctor may prescribe cholesterol-lowering drugs, blood pressure lowering drugs, and aspirin. If the blockage cannot be cleared with these drugs, your doctor may suggest a surgery.

Carotid endarterectomy is the most common and effective carotid artery surgery used to clear the plaques. During the surgery, your doctor makes an incision at the front of your neck and opens the carotid artery. Then, your doctor removes the plaque and repairs the artery by suturing.

Carotid angioplasty and stenting are suggested if the carotid endarterectomy may pose a risk due to the underlying medical condition. The angioplasty procedure involves inserting a tiny balloon into your artery through a catheter. The affected artery is widened by inflating the balloon and then, a stent is placed to keep the artery from narrowing.

The carotid artery disease can be prevented by considering following changes in your daily life:

  • Smoking cessation
  • Maintaining a healthy weight
  • Avoiding the intake of food rich in fats and cholesterol
  • Increasing the intake of fruits and vegetables
  • Limiting the intake of salt
  • Avoiding alcohol consumption
  • Performing regular physical activity