The carotid arteries supply blood, oxygen, and other nutrients to the brain. If these arteries become diseased, they can cause strokes.
Definition of Carotid Stenosis
Carotid stenosis is the buildup of atherosclerosis in the carotid arteries. Diet, genetics, lifestyle and other chronic medical problems all play a role in determining the presence and extent of carotid disease. Smoking also increases the severity and likelihood of the disease. Plaque in the arteries can break off and become emboli and cause a stroke. In addition, the severe lack of blood flow caused by the stenosis can also cause a stroke.
Anatomy of Carotid Stenosis
The carotid arteries carry oxygenated blood from the heart to the brain. The carotid arteries are located bilaterally in the neck on either side of the trachea. Each common carotid artery divides in the neck to become the internal and external carotid arteries, which supply the brain and face, respectively.
Causes of Carotid Stenosis
Atherosclerosis is the main cause of carotid stenosis. This is the creation of plaque within arteries. This can be accelerated with tobacco use. High cholesterol, diet, and genetics can also play a part in developing the disease.
Symptoms of Carotid Stenosis
- A brief lack of vision, like a shade coming down over the eye that spontaneously resolves
- Numbness or paralysis of an extremity
Any of these symptoms require immediate medical attention.
Diagnosis of Carotid Stenosis
The diagnosis of carotid stenosis is made based on ultrasound or other imaging. Physicians suspect carotid disease with periodic vision loss called “amaurosis fug ax” or a history of one-sided numbness or paralysis. The physician will also use a stethoscope to listen for a “bruit,” or an abnormal sound over the carotid artery as blood flows through the stenotic region.
Prevention of Carotid Stenosis
Prevention of carotid stenosis revolves around lifestyle and adequately treating medical conditions. Patients need to make sure hypertension is within normal range. Accordingly, diabetics should take their medications and monitor blood sugars. Patients with elevated cholesterol levels should be on a statin. For those patients with evidence of carotid stenosis on ultrasound, a statin and aspirin are key to preventing more severe disease. Also, a healthy diet will also help to minimize atherosclerosis that might build up and lead to carotid stenosis.
Am I At Risk for Carotid Stenosis?
Patients with one area of the body with atherosclerosis, such as coronary disease, are more likely to have atherosclerosis of other parts of the body. Some people have a genetic predisposition to higher cholesterol levels or hypertension. Patients should see a physician regularly to monitor their blood pressure and cholesterol. Maintaining a healthy diet and body weight, as well as treating chronic medical conditions can reduce the risk of developing carotid stenosis.
Treatment of Carotid Stenosis
Carotid stenosis can be treated with open or endovascular means. The open procedure cleans the plaque from the artery to allow adequate blood flow. This procedure is called a carotid endarterectomy. For those patients with a symptomatic disease who cannot tolerate open surgery, a carotid stent can be placed. This is an endovascular procedure that is performed with stents and wires. Many patients with mild or moderate asymptomatic disease can be managed with medications.
To learn more about treatment procedures for this condition please visit the following:
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