Carotid Artery Disease
Overview
Treatments
The carotid arteries supply your brain with blood and are the main arteries in your neck.
“Plaque” is built up by the carotid arteries as you age, this is a substance made up of fat and cholesterol. Plaque makes your arteries stiff and causes them to narrow, a process called atherosclerosis or “hardening of the arteries.”
Carotid artery disease (CAD) occurs because carotid arteries become blocked and narrowed due to the buildup of plaque. When they narrow, also referred to as carotid artery stenosis, it can cause strokes or “mini-strokes.”
Up to 3% of individuals older than 65 have CAD. This risk increases as you age and with a history of smoking , high cholesterol, high blood pressure, diabetes, or heart disease. CAD causes up to one-third of all strokes.
About 700,000 strokes occur every year. Strokes are responsible for 1 in every 15 deaths.
Symptoms
You may not experience any symptoms in the early stages of CAD. Sometimes, the first sign of the disease is a stroke.
However, strokes usually have warning signs. This includes mini-strokes, also referred to as transient ischemic attacks (TIAs). TIA symptoms are typically temporary, lasting a few minutes to a few hours. TIAs should be treated as serious medical emergencies and require immediate medical attention.
Some symptoms of TIA and stroke include:
Weakness, tingling, or numbness on one side of the body
Loss of vision or blurred vision in one or both eyes
Inability to control movement of a body part
Difficulty talking or comprehending what others are saying
Inability to speak clearly
Causes and Risks
Older Age
Smoking
Family History
High cholesterol
Diabetes
Lack of exercise
High blood pressure
Obesity
Diagnosis
Talk to a Doctor
If you think you are having TIA or a stroke, you should get emergency medical help immediately.
Diagnosis
If your doctor thinks that you may have CAD, they will recommend a noninvasive carotid duplex ultrasound exam. The ultrasound results will confirm if you have CAD and its severity.
Role of a Vascular Surgeon
If CAD is confirmed or suspected, you may be referred to a vascular surgeon. Vascular surgeons are experts in this diagnosis, medical management, and all of the procedural options (surgery or stents) to treat CAD.
It is important to get treatment for CAD to reduce your risk of stroke or to prevent another stroke from occurring. Treatment depends on the severity of your condition and may include:
Medication: Often a combination of different medications can lower the risk of stroke and can help slow the progression of CAD. Aspirin and other medications (like clopidogrel, prasugrel, and ticagrelor) that “thin” the blood decrease your risk of stroke. Medications that lower your cholesterol and blood pressure are also common in treatment to keep the blockage from getting worse. Your doctor may adjust your medication over time.
Quitting Smoking: This is an important part of treatment to be able to manage CAD and for your overall health.
Surgery: If the degree of narrowing is more than 60%, in addition to medication, you may need surgery.
Carotid artery stenting: A less invasive procedure where a stent (small, mesh tube) is placed in the artery to keep it open.
Some people with CAD, even if they do not have symptoms, benefit from surgery.
What can I expect after treatment?
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