Carotid Artery Disease is a form of disease that affects the vessels leading to the head and brain (cerebrovascular disease). Like the heart, the brain's cells need a constant supply of oxygen-rich blood. This blood supply is delivered to the brain by the 2 large carotid arteries in the front of your neck and by 2 smaller vertebral arteries at the back of your neck. The right and left vertebral arteries come together at the base of the brain to form what is called the basilar artery. A stroke most often occurs when the carotid arteries become blocked and the brain does not get enough oxygen.
Carotid Artery Disease Increases The Risk Of Stroke In 3 Ways:
- By fatty deposits called plaque severely narrowing the carotid arteries.
- By a blood clot becoming wedged in a carotid artery narrowed by plaque.
- By plaque breaking off from the carotid arteries and blocking a smaller artery in the brain (cerebral artery).
Signs and Symptoms
Carotid artery blockages are caused by hardening of the arteries, called atherosclerosis. Risk factors for atherosclerosis include:
- High blood pressure
- High cholesterol
- Smoking cigarettes
Strokes occur when pieces of the diseased artery break off and travel into the brain, eventually blocking blood flow, causing part of the brain to die. This can either cause a full-blown stroke, resulting in permanent neurological problems in a minority of people, a or a transient ischemic attack (TIA), which produces the same symptoms as a stroke but resolves in less than a day, often in a matter of minutes.
Symptoms of both stroke and a transient ischemic attack (TIA) include:
- Weakness or paralysis of a limb or one side of the body
- Inability to speak or articulate clearly
- Blindness or other visual changes in one or both eyes
Carotid artery blockages can be diagnosed easily with ultrasound imaging, a painless and safe procedure that is performed on an outpatient basis.
If a more detailed image is needed to determine if surgery is required, your doctor may order other tests such as:
- Computerized tomography (CT) scan
- Magnetic resonance angiogram (MRA
Mild to moderate blockages in the carotid artery are treated with medications called antiplatelet agents, such as aspirin, that block the formation of blood clots. In addition, treatment involves identifying and reducing risk factors, such as cigarette smoking and high blood pressure.
Ultrasound studies are repeated over time to monitor the blockage.
If your carotid artery disease progresses, you may need surgery.
A number of large studies in the 1990s demonstrated that surgery — called Carotid Endarterectomy — was the best treatment for reducing the risk of stroke in patients with severe blockages in the carotid arteries. Research continues, however, on new, less invasive procedures, such as carotid artery stenting.
Carotid Artery Endarterectomy involves:
- Opening the artery
- Removing the plaque that is causing the narrowing
- Closing the artery, usually with a synthetic patch
During surgery, a temporary bypass is often used to allow blood to flow around the area of surgery as it travels to the brain.
Not all patients are candidates for surgery, particularly those patients who are in overall poor health or have other health issues.
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