Carotid Artery Stenosis

(Internal Carotid Artery Stenosis; Carotid Artery Disease)

Pronounced: kah-rah-tid ar-tur-ree steh-noh-sis

Definition

Definition

Carotid artery stenosis occurs when the carotid arteries narrow. The carotid arteries are major arteries found on each side of the neck. They supply blood from the heart to the brain.

This condition is a major risk factor for ischemic stroke. Ischemic stroke is when blood flow to the brain is blocked due to blood clots.

Blood Supply to the Brain

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Causes

Causes

Carotid artery stenosis is caused by the build-up of plaque along the lining of the arteries. This build-up is known as atherosclerosis. Plaque is made up of cholesterol, fat, and other substances.

Risk Factors

Risk Factors

Carotid artery stenosis is more common in men aged 75 or younger and women aged 75 or older. Risk factors include:

Symptoms

Symptoms

There are usually no symptoms. Tell your doctor if you have symptoms of a stroke or a transient ischemic attack (TIA or mini-stroke). This is a warning sign that you may have carotid artery stenosis. Symptoms may include:

  • Blindness, blurry or dim vision
  • Weakness, numbness, or tingling of the face, arm, leg, or one side of the body
  • Difficulty speaking or understanding words
  • Lightheadedness, unsteadiness of gait, or falling
  • Trouble with balance or coordination
  • Loss of consciousness
  • Nausea or vomiting
  • Sudden confusion or loss of memory

Diagnosis

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.

Images may be needed of your internal structures. This can be done with:

Treatment

Treatment

The goal of treatment is to prevent carotid artery stenosis from causing inadequate blood flow to the brain or causing a stroke. Treatment will depend on:

  • The severity of your condition
  • Your symptoms

Talk with your doctor about the best treatment plan for you. Treatment options include:

Medication and Lifestyle Changes

If there are no symptoms and if plaque build-up is not severe, medications like aspirin may be given to help prevent a stroke from occurring. Lifestyle changes are also an important part of treatment. Some actions you can take to reduce your risk of stroke include:

  • Eat a healthy diet.
  • Exercise regularly.
  • If you smoke, talk to your doctor about ways to quit.
  • If you have diabetes, get proper treatment.
  • If you have high cholesterol, work with your doctor to lower the levels.
  • If you have high blood pressure, work to get it under control.

Surgery

Surgery may be needed if the arteries have severe plaque build-up. One kind of surgery is called carotid endarterectomy. This involves opening the artery and cleaning the plaque from it. Another surgery that may be done is carotid angioplasty and stenting. In this surgery, a balloon is inserted into the artery to widen it. Then a metal mesh, called a stent, is inserted to keep the artery open so that blood can flow freely.

Prevention

Prevention

To help reduce your chance of getting carotid artery stenosis, you will need to decrease the risk factors that you can control. For example, you can reduce your cholesterol, blood pressure, and weight. Here are some steps to decrease these risk factors:

  • Exercise regularly.
  • Eat more fruits and vegetables. Limit dietary salt and fat.
  • If you smoke, talk to your doctor about ways to quit.
  • If you drink alcohol, do so only in moderation. This means having no more than 2 drinks per day if you are a man, and no more than 1 drink per day if you are woman.
  • Maintain a healthy weight.
  • Keep your blood pressure in a safe range. Follow your doctor’s recommendations if you have high blood pressure.
  • Keep other conditions under control. This includes high cholesterol and diabetes.

RESOURCES:

American Heart Association http://www.heart.org

National Stroke Association http://www.stroke.org

CANADIAN RESOURCES:

Heart and Stroke Foundation of Canada http://www.heartandstroke.ca

Prevent Stroke http://www.preventstroke.ca

References:

Buckley L, Schub T. Carotid stenosis. EBSCO Nursing Reference Center website. Available at:
http://www.ebscohost.com/nursing/products/nursing-reference-center
Updated June 27, 2014. Accessed March 11, 2015

Carotid artery stenosis. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated February 18, 2015. Accessed March 11, 2015.

Last reviewed March 2015 by Michael J. Fucci, DO
Last Updated: 5/2/2014

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