By Dr Ananya Mandal, MD
Carotid artery stenosis refers to narrowing of the carotid arteries, major vessels that run through both sides of the neck carrying blood to the brain from the heart. Also called carotid artery disease, the condition reduces the supply of blood to the brain, which is a major risk factor for stroke or a transient ischemic attack (TIA or mini-stroke).
The lumen of the carotid artery narrows in a condition called atherosclerosis, which refers to the build up of fatty deposits or plaques on the inside of the artery. These plaques can harden and thicken the arterial wall which loses the usual elastic recoil that occurs as blood pulses through it.
Some examples of the risk factors for carotid artery stenosis include:
- Old age
- Family history of the disease
- Past or current smoking
- High blood pressure
- High blood cholesterol
There are often no symptoms of carotid artery stenosis but patients should tell their doctor if they experience any of the following symptoms, which can indicate TIA. Although TIA is often referred to as a mini-stroke, it is also sometimes called a warning stroke.
- Sudden confusion
- Loss of consciousness
- Difficulty speaking
- Difficulty balancing or coordinating movement
- Nausea or vomiting
- Blurred vision
- Weakness, tingling or numbing of the arm, leg or face on one side of the body or paralysis of limbs
A doctor will obtain details of symptoms and medical history as well as performing a physical examination. The doctor will use a stethoscope to listen to the blood flow through the carotid arteries.
Tests that may be performed include:
Carotid ultrasonography – This technique uses high intensity sound waves to generate structural images of the carotid arteries which can be used to check for plaque build up and clots.
Carotid angiography – A catheter is inserted into a vein in the patient’s arm or leg and guided towards the carotid arteries. A contrast dye is then passed through the catheter and X-ray images of the carotid arteries are taken.
Magnetic resonance imaging (MRI) uses magnetic fields to create detailed images of the arteries.
In cases of no symptoms and only a mild build up of plaque, aspirin may be prescribed to help prevent a stroke occurring. Lifestyle changes may also be advised such as eating a healthy diet, exercising regularly, maintaining a healthy weight, quitting smoking, keeping diabetes under control and trying to reduce raised cholesterol or blood pressure.
In more severe cases, surgery may be required to open the artery and remove the plaque. Another surgical procedure is carotid angioplasty and stent insertion. For this surgery, a small balloon is inserted into the artery and inflated to widen the narrowing and a mesh stent put in place to keep the artery open for proper blood flow.
Reviewed by Sally Robertson, BSc
Last Updated: Apr 14, 2014