Carotid Artery Disease
Cholesterol is a waxy substance, which tends to deposit on the walls of blood vessels all over the body. When cholesterol plaque builds-up on the inner surface of carotid arteries, it cases their narrowing (stenosis) and as a result leads to the development of the carotid artery disease, which in turn increases the risk of stroke. Carotid artery disease symptoms may be missing on early stages of the disease. The primer goal of the carotid artery disease treatment is to prevent stroke. The choice of treatment option depends on the extent of narrowing and overall health of a patient. More detailed information about this condition, its` symptoms, diagnostics services and treatment options is presented below.
So, let us talk about the disease where plaque (waxy substance) builds up inside the carotid arteries. The human body has 2 common carotid arteries; 1 on each side of the neck and they each divide into internal and external carotid arteries.
- Internal carotid arteries: Supply oxygen-rich blood to your brain
- External carotid arteries: Supply oxygen-rich blood to your face, scalp, and neck
This diseases is dangerous as it can cause a stroke (brain attack). When blood flow to your brain is cut off, a stroke occurs. When blood flow is cut off for more than a few minutes, brain cells start to die. This impairs the parts of the body that the brain cells control. A stroke can cause:
- Lasting brain damage
- Vision or speech problems
Plaque hardens over time and narrows the arteries which may limit the flow of oxygen-rich blood to vital organs and other parts of your body. Blood clots form in the carotid arteries can also cause a stroke. It can occur when plaque in an artery cracks or ruptures. Blood cell fragments called platelets may stick to the site of the injury and clump together to form blood clots. Blood clots may partly or fully block a carotid artery.
Plaque or a blood clot may also break away from the wall of the carotid artery and may travel through the bloodstream and get stuck in one of the brain’s smaller arteries. This may block blood flow in the artery and cause a stroke.
There may be no signs or symptoms until the carotid arteries are severely narrowed or blocked. A stroke is the first sign of the disease for some people.
What are the causes of carotid artery disease?
It occurs due to the damage to the inner lining of the artery. It’s a gradual process that is associated with smoking, high blood pressure, high cholesterol levels and poorly controlled diabetes that may all cause minor damage to the inner walls of an artery. During the healing process, inflammation may occur and plaque may begin to form.
The area of plaque may grow over time and narrow the lumen of the artery. It becomes a circle as the narrow lumen increases pressure within the artery and blood turbulence and will lead to more arterial wall damage and more plaque formation.
CAROTID ARTERY DISEASE SYMPTOMS
Carotid artery disease often show no signs or symptoms in the early stages. It may go unnoticed until it’s serious enough to deprive your brain of blood causing a stroke.
Signs and symptoms of a stroke:
- Sudden numbness or weakness felt on the face or limbs (often on only one side)
- Sudden trouble speaking and understanding speech
- Sudden trouble seeing in 1 or both eyes
- Sudden dizziness or loss of balance
- Sudden, severe headache with no known cause
CAROTID ARTERY DISEASE TREATMENT OPTIONS
The goal of treatment is to prevent stroke. Depending on the extent of blockage in your carotid arteries, specific treatment is required.
If blockage is mild to moderate, your doctor may recommend:
- Lifestyle changes: Slow the progression of the disease. Changes include include quitting smoking, losing weight, eating healthy foods, reducing salt and exercising regularly.
- Medication: Control blood pressure or lower cholesterol. A daily dose of aspirin or other blood-thinning medication may be recommended to prevent blood clots.
If blockage is severe or you’ve already had a stroke, removing the blockage from the artery may be recommended. The options include:
- Carotid endarterectomy: Most commonly used to treat severe carotid artery disease. An incision along the front of your neck is made where the surgeon opens the affected carotid artery and removes the plaques. The artery is repaired with stitches or a graft.
- Carotid angioplasty and stenting: This procedure may be considered if the blockage is too difficult to reach with carotid endarterectomy or if you have other health conditions that make surgery too risky. Local anesthesia is administered and a tiny balloon is threaded by a catheter to the area of the clog. Inside, the balloon is inflated to widen the artery and a small wire mesh coil (stent) is inserted to keep the artery from narrowing.
DIAGNOSING CAROTID ARTERY DISEASE
- Physical Exam: Your doctor will listen to your carotid arteries with a stethoscope to listen for a whooshing sound (bruit) as it may indicate changed or reduced blood flow due to plaque buildup. Your doctor may order more tests to further examine your condition.
- Carotid Ultrasound (sonography): The most common test for carotid artery disease diagnosis. Sound waves are used to create pictures of the insides of your carotid arteries. It can show whether plaque has narrowed your carotid arteries and how narrow they are. A standard carotid ultrasound can show the structure of your carotid arteries. A Doppler carotid ultrasound is able to show how blood moves through your carotid arteries.
- Carotid Angiography: A special type of x ray. May be used if the ultrasound results are unclear or don’t give your doctor enough information. Contrast dye is injected into a vein, most often in your leg to make your veins show up clearer.
- Magnetic Resonance Angiography: A large magnet and radio waves to take pictures of your carotid arteries. Contrast dye is injected into your vein to highlight your carotid arteries on the pictures.
- Computed Tomography Angiography: X-ray pictures of the body from many angles. A computer will then combine the pictures into 2D and 3D images. Contrast dye is injected into your vein to highlight your carotid arteries on the pictures.