Carotid artery disease is a condition in which plaque builds up inside the carotid arteries. You have two common carotid arteries-one on each side of your neck-that divide into internal and external carotid arteries. The internal carotid arteries supply oxygen-rich blood to your brain. The external carotid arteries supply oxygen-rich blood to your face, scalp and neck.
Carotid artery disease can be serious because it can cause a stroke, which occurs when blood flow to your brain is blocked. If blood flow is cut off for more than a few minutes, the cells in your brain start to die. This impairs the parts of the body that the brain cells control. A stroke can cause lasting brain damage, long-term disability, paralysis or death. You have the best chance for full recovery if treatment to open a blocked artery is given within six hours of symptom onset. Ideally, treatment should be given within three hours of symptom onset.
Carotid artery disease appears to start when damage occurs to the inner layers of the carotid arteries. Major factors that contribute to damage include:
When damage occurs, your body starts a healing process. The healing may cause plaque to build up where the arteries are damaged. Over time, the plaque may crack. Blood cells called platelets stick to the injured lining of the artery and may clump together to form blood clots. The buildup of plaque or blood clots can severely narrow or block the carotid arteries. This limits the flow of oxygen-rich blood to your brain and can cause a stroke.
Certain traits, conditions or habits may raise your risk for carotid artery disease. These conditions are known as risk factors. The more risk factors you have, the more likely you are to get the disease. You can control some, but not all, risk factors.
The major risk factors for carotid artery disease, listed below, also are the major risk factors for coronary artery disease and heart disease.
Having any of these risk factors doesn't mean you will get carotid artery disease. However, if you have one or more risk factors, you can take steps to help prevent the disease, including following a healthy lifestyle and taking medicines your doctor prescribes.
Carotid artery disease may not cause signs or symptoms until it severely narrows or blocks the carotid arteries. Signs and symptoms may include a bruit, a transient ischemic attack or a stroke.
During a physical exam, your doctor may listen to your carotid arteries with a stethoscope. He or she may hear a whooshing sound called a bruit. This sound may suggest changed or reduced blood flow due to plaque. To find out more, your doctor may order tests. Not all people who have carotid artery disease have bruits.
•· Transient Ischemic Attack
For some people, having a TIA, or "mini-stroke," is the first sign of carotid artery disease. During a mini-stroke, you may have some or all of the symptoms of a stroke. However, the symptoms usually go away on their own within 24 hours. The symptoms may include:
Most people who have carotid artery disease don't have mini-strokes before they have strokes. The symptoms of stroke are the same as those of mini-stroke, but the results are not. A stroke can cause lasting brain damage, long-term disability, paralysis or even death.
Your doctor will diagnose carotid artery disease based on your medical history and the results from a physical exam and tests. The following tests are common for diagnosing carotid artery disease. If you have symptoms of a mini-stroke or stroke, your doctor may use other tests as well.
Treatments for carotid artery disease may include lifestyle changes, medicines and medical procedures. The goals of treatment are to stop the disease from getting worse and to prevent a stroke. Your treatment will depend on your symptoms, how severe the disease is, and your age and overall health.
Making lifestyle changes often can help prevent carotid artery disease or keep it from getting worse. For some people, these changes may be the only treatment needed:
You may need medicines to treat diseases and conditions that damage the carotid arteries. High blood pressure, high blood cholesterol and diabetes can worsen carotid artery disease.
You may need a medical procedure to treat carotid artery disease. Doctors use one of two methods to open narrowed or blocked carotid arteries.
•· Carotid Endarterectomy
This treatment is mainly for people whose carotid arteries are blocked 50 percent or more. For the procedure, a surgeon will make a cut in your neck to reach the narrowed or blocked carotid artery. He or she will make a cut in the artery and remove the plaque inside. The artery and your neck will then be stitched up.
•· Carotid Artery Angioplasty and Stenting
Doctors use angioplasty to widen the carotid arteries and restore blood flow to the brain. A thin tube with a balloon on the end is threaded through a blood vessel in your neck to the narrowed or blocked carotid artery. Once in place, the balloon is inflated to push the plaque outward against the wall of the artery. A stent (a small mesh tube) is then put in the artery to hold the plaque back and keep the artery open.