Carotid Artery Disease: A Stroke Risk You May Be Able to Prevent

The carotid arteries are the main conduits for blood flow to the brain. You can feel the blood pulsing through the carotids on either side of your neck. These arteries, like those of the heart, are also vulnerable to narrowing or blockage from atherosclerosis, which can cause a stroke.

A stroke is to the brain what a heart attack is to the heart. Both block life-giving oxygen to these vital organs.

What is carotid artery disease?
Carotid artery disease occurs when the vessels become narrowed or blocked from atherosclerosis. Blocked or reduced blood flow to the brain can lead to a stroke.

Atherosclerosis is the term for what is commonly called "hardening of the arteries." Cholesterol and other fatty substances build up along an artery's inner lining, forming a plaque. This buildup can cause a stroke in two ways.

• The blockage prevents or reduces blood flow to the brain.
• A small piece of plaque breaks off and travels through the blood to block a blood vessel elsewhere in the brain. This can cause a stroke or a transient ischemic attack (TIA, or "mini-stroke").

How do you know if you have carotid artery disease?
You can have carotid artery disease without any symptoms. The first sign may be a TIA or stroke. A TIA is a temporary blocking of blood flow to the brain and is a warning sign of an impending stroke. If you have these symptoms of a stroke or TIA, call 9-1-1 and get immediate medical attention:

• Blurred vision or loss of (or graying) vision in one or both eyes
• Weakness, numbness or tingling in your arm, leg or face
• Difficulty talking or slurred speech
• Dizziness, confusion or loss of coordination
• Difficulty swallowing
• Sudden, severe headache

There are tests that can detect carotid artery disease. Your doctor may:

• Listen to your carotid arteries through a stethoscope for the sound (called a bruit) of abnormal blood flow
• Perform a carotid ultrasound to check how well blood is flowing through your arteries

If your doctor thinks you have carotid artery disease, you may need more tests to find out how severe the blockage is. These tests may include imaging tests such as a CT scan, MRI or an angiogram. For an angiogram, dye is injected into your veins so detailed pictures can be taken.

How can you prevent carotid artery disease?
Your chances of getting carotid artery disease increase with age. But there is a lot you can do to prevent it or keep it from getting worse:

• Don't smoke. Smoking is one of the main risk factors for the development of this disease.
• Control your blood pressure and cholesterol level.
• Control diabetes.
• Eat a healthy, low-fat diet.
• Get regular exercise. Talk with your doctor before you begin.
• Limit alcohol.

If you have atrial fibrillation, a form of irregular heart beat, you may need blood-thinning medications called anticoagulants. Atrial fibrillation raises your risk for stroke.

What treatments are available for carotid artery disease?
Treatment for carotid artery disease depends on its severity, as well as your overall health. It's important to follow healthy lifestyle practices to help keep it under control.

• If blockages are not severe, you doctor may give you blood-thinning medicines, such as aspirin or anticoagulants, to help prevent clotting.
• If you have a severe blockage (causing more than 70 percent narrowing of your artery) or have had a TIA or stroke, you may need to have the blockage removed. This can be done through:
• Carotid endarterectomy. This is a surgical procedure that can reopen the artery and restore blood flow to normal. In this operation, the surgeon makes an incision in your neck and removes the plaque buildup inside the carotid artery.
• Carotid angioplasty with stenting. This is a newer and less-invasive procedure that may be an alternative to surgery for certain people. In this procedure a small tube with a balloon attached is inserted into a vein in your groin and threaded up through your blood vessels to your carotid artery. The balloon is inflated to open the artery. Next, a stent (a tiny, flexible mesh tube) is inserted to keep the artery open and prevent future blockages.

If you have carotid artery disease, work with your doctor to make healthy lifestyle changes and follow your treatment plan so you can avoid serious complications.

Related Articles What is Stroke? Lowering Your Risk for Stroke

External Sources National Stroke Association. What is a stroke/brain attack? Accessed October 30, 2007. Sobieszczyk P, Beckman J. Carotid artery disease. Circulation. 2006;114:e244-e247. The Society for Vascular Surgery. VascularWeb. Carotid artery disease. Accessed October 30, 2007. National Institute of Neurological Disorders & Stroke. NINDS transient ischemic attack information page. Accessed October 30, 2007. American Heart Association. Transient ischemic attack. Accessed October 30, 2007.

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