Carotid Artery Disease
Understanding and Treating Carotid Artery Disease
Carotid Artery Disease is a condition that affects the carotid arteries in the neck that supply blood to the brain. This disease is the narrowing or blockage of the carotid arteries from plaque buildup called atherosclerosis. Restricted blood flow in these critical arteries increases the risk of a stroke because the brain is not getting sufficient blood flow from the heart.
What is the Carotid Artery Disease?
Carotid Artery Disease is a condition where four major blood vessels in the neck that supply blood to the brain, the carotid arteries, become narrowed or blocked due to plaque buildup. Plaque buildup, known as atherosclerosis, restricts blood flow in the carotid arteries that distribute blood to the brain which can increase the risk of a stroke or mini-stroke in patients with Carotid Artery Disease. Plaque formation in the carotid arteries is often related to risk factors such as high blood pressure, high cholesterol, diabetes, smoking, underlying vascular conditions, or a family history of vascular disease. Early diagnosis and treatment of Carotid Artery Disease is essential to reducing the risk of stroke and maintaining proper blood flow to the brain.
Carotid Artery Disease Symptoms
Carotid artery disease may be asymptomatic in its early stages, meaning there may be no visible symptoms until a serious event occurs. When symptoms do present, they may include:
- Sudden Numbness or Weakness: Particularly on one side of the body.
- Speech Difficulties: Trouble speaking, understanding speech, or slurred words.
- Visual Impairments: Sudden loss of vision or visual disturbances in one or both eyes.
- Facial Drooping: Weakness or drooping on one side of the face.
- Severe Headache: A sudden, intense headache without a known cause.
If these symptoms appear and then resolve within 24 hours, it is likely a transient ischemic attack (“mini-stroke”). If symptoms persist, they may indicate a stroke. Both scenarios require immediate medical attention, as they signal a high risk of further complications.
Causes of Carotid Artery Disease
Carotid artery disease is commonly caused by atherosclerosis, a condition where plaque builds up in the arteries. Atherosclerosis can be caused by a wide range of risk factors, habits and conditions. Plaque is a sticky substance that accumulates along arterial walls. As plaque continues to stick to arterial walls it builds up in spots along the artery which narrowing tube structure from the inside since the plaque acts as a bottleneck in the vessel that restricts normal blood flow. This buildup often results from factors that increase or accelerate the development of plaque, including high blood pressure, high cholesterol, diabetes, smoking, a family history of vascular disease and underlying vascular conditions. These risk factors contribute to the weakening of artery walls and the formation of plaque over time, making it difficult for blood to flow smoothly through the arteries. The reduced blood flow heightens the risk of stroke or transient ischemic attack as pieces of plaque or blood clots can break off and travel to the brain which causes an embolism in the brain which can cause a stroke.
Diagnostic Methods for Carotid Artery Disease
Early and accurate diagnosis of carotid artery disease is vital in preventing strokes and other complications. Common diagnostic methods include:
- Physical Examination: Doctors may detect a bruit, a whooshing sound in the neck, which can indicate abnormal blood flow in the carotid artery due to a narrow passageway for the blood flow in the artery due to plaque buildups.
- Carotid Vascular Ultrasound: A non-invasive test using sound waves to visualize the carotid arteries in the neck to visualize and measure blood flow to the brain to detect potential blockages or narrowing in the arteries.
- CT or MRI Scan: Advanced imaging techniques, often with contrast dye, provide a detailed view of the carotid arteries and help plan for treatment.
- Angiography: This minimally invasive test uses X-rays and contrast dye to view blood flow and confirm the extent of blockage in the carotid arteries.
Carotid Artery Disease Treatment Options
Treatment for carotid artery disease depends on the extent of the plaque buildup in the arteries, the location of the buildups and the patient’s overall health. Treatment options at Glendale vascular for Carotid Artery Disease range from lifestyle management to surgical interventions:
- Lifestyle Changes and Medication: For mild cases that are asymptomatic and small the best course of action is sometimes managing cholesterol, blood pressure and blood sugar levels, along with quitting smoking and changing other negative lifestyle habits to slow the plaque buildup. Blood-thinning medications, such as aspirin, may also be recommended to prevent clotting. This only applies if the risk of the surgical operation is greater than the risk of the condition to the patient due to its size and relative stability.
- Carotid Endarterectomy is the Gold Standard of Treatment: Endarterectomy is a surgical procedure that removes plaque buildup directly from the artery through an incision in the neck. The surgeon temporarily reroutes blood flow, removes the plaque, and restores normal blood flow by closing the artery.Carotid Endarterectomy is often recommended for patients with significant blockages, as it is effective in reducing the risk of a stroke and effectively reduces the plaque buildup to restore normal blood flow levels.
- Carotid Artery Stent: For patients at high surgical risk, a small incision will be made in the groin area and a catheter will be inserted with a stent that is directed to the carotid artery to hold the artery open and maintain normal blood flow. Although this is a minimally invasive, this endovascular procedure carries a slightly higher risk of stroke than Carotid Endarterectomy because there is a greater chance of plaque in the carotid artery breaking loose and going to the brain during and after the procedure.
- Transcarotid Artery Revascularization (TCAR): TCAR is a newer approach to treating Carotid Artery Disease where the surgeon makes a small incision in the neck, inserts a specialized catheter and a device that reverses the flow of blood in the carotid artery, that reversed blood is pulled into a device that filters out any plaque debris and returns the blood to vessel in the leg. The blood reversal system is to prevent the brain during the procedure incase any plaque breaks free while the stent is being positioned and enlarged to open the artery.
Each treatment method aims to restore normal blood flow, reduce the risk of stroke, and improve long-term vascular and brain health. Treating carotid artery plaque buildups is vitally important to protecting blood flow to the brain and reducing the risk of strokes.
Patient Prognosis for Carotid Artery Disease
The prognosis for carotid artery disease depends on the severity of the initial condition and success of the treatment. With early diagnosis and effective treatment, many patients experience improved blood flow to the brain and a significantly reduced risk of stroke. Following procedures like carotid endarterectomy (CEA), carotid artery stenting (CAS) and transcarotid artery revascularization (TCAR), patients generally have favorable outcomes, with decreased symptoms and restored circulation. The risk of the arteries re-narrowing or restenosis always remains with carotid artery disease, which is why long-term management and vascular monitoring is crucial.
Contact Glendale Vascular for Carotid Artery Disease Diagnosis and Treatment
Patients with symptoms of carotid artery disease or are at risk due to family history or other health factors should contact Glendale Vascular for the diagnosis and treatment of carotid artery disease. Our experienced medical team provides comprehensive assessments, advanced treatments and ongoing support to reduce stroke risk and improve vascular health. Contact us today to schedule an appointment to take proactive steps toward better vascular health.