Medically Reviewed by Christopher G. Cunningham, MD

Carotid artery disease is the major cause of stroke and a leading cause of disability in the United States.

WHAT IS IT?

Two large arteries flow from the heart up the sides of the neck and into the brain. They supply oxygen to the parts of the brain that control our movements and our ability to think, speak and experience our senses of touch, taste, sight, sound and feel.

As we age, deposits of cholesterol, calcium and other cells (called plaque) build up on the walls of these arteries.  Smoking, lack of exercise, obesity and bad diet worsen the narrowing and blockage (stenosis).

When your physician listens to your neck with a stethoscope, he/she may hear a “whooshing” sound that signals a buildup or reduced blood flow in the artery.

Another sign is a “mini-stroke” (transient ischemic attack or TIA), in which you may have symptoms of a stroke but they go away. A TIA is a warning sign of an impending stroke.

Some people may not notice the problem in its early stages. Unfortunately, the first signs may be a stroke, when the blockage is severe or a piece of the plaque breaks off, halting the flow of blood.

Brain cells start to die if blood flow is cut off for just a few minutes. Brain damage can be permanent if the blood flow is blocked for more than 5 or 10 minutes.

There are warning signs that indicate someone could be experiencing a stroke.  DO NOT IGNORE these symptoms.  If you have numbness in your face or arms and legs, trouble speaking or seeing, dizziness or a severe headache, call 911 for help.  DO NOT drive yourself to the hospital.

The best way to avoid the catastrophic stroke is to see your doctor regularly for a check up.

DIAGNOSIS.

A specialist will use an ultrasound machine to image or measure the blood flowing through the artery.  The specialist might also look at the neck’s blood flow using an X-ray, CT or MRI image (angiogram).

“Diagnostic testing would be recommended for anyone at risk for a stroke to check for blockages in the carotid artery,” said McLeod Vascular Surgeon Dr. Christopher Cunningham.  “When plaque builds up in the artery, and blood flow is reduced, it can cause a stroke.  I encourage everyone over the age of 60 to talk to their primary care physician about a carotid screening and earlier if there is a family history of stroke.”

TREATMENT

At the direction of a physician, patients can take aspirin to improve blood flow.  A class of medication called “statins” is used to reduce cholesterol in the blood system.  Their use has reduced stroke by as much as 40% since 1995.

If the artery is about 70% closed, one of several medical procedures can be recommended.

• Carotid Endarterectomy. A vascular surgeon will make an incision in your neck. The material blocking the artery (plaque) will be removed by the vascular surgeon.
• Carotid Artery Angioplasty & Stenting. After thin tube is inserted into the blocked artery, a small balloon inflates.  The material blocking the blood flow is compressed against the artery wall.  A small mesh tube (stent) is then placed inside the artery to keep it from growing closed again.

These two techniques are not interchangeable as one may be better than the other depending on the type of blockage.  The vascular surgeon will determine the best form of treatment.

FINAL THOUGHT.
Since the symptoms of carotid artery disease don’t’ give you much warning, the best approach is to do what you can to avoid accelerating the clogging of these critical arteries.

As with all cardiac, heart and vascular issues the most important lifestyle changes are to stop smoking and control your weight by exercising and eating a low-fat diet.

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Sources: McLeod Health, Vascular Disease Foundation, Society for Vascular Surgery, National Institutes of Health, Circulation Foundation, National Stroke Foundation