Carotid artery disease

Definition

Carotid artery disease occurs when the carotid arteries become narrowed or blocked.

The carotid arteries provide part of the main blood supply to your brain. They are located on each side of your neck. You can feel their pulse under your jawline.

Alternative Names

Carotid stenosis; Stenosis - carotid; Stroke - carotid artery

Causes

Carotid artery disease occurs when fatty material called plaque builds up inside the arteries. This buildup of plaque is called atherosclerosis (hardening of the arteries).

The plaque may slowly block or narrow the carotid artery. Or it may cause a clot to form suddenly. A clot that completely blocks the artery can lead to stroke.

Risk factors for blockage or narrowing of the arteries include:

Symptoms

At early stages, you may not have any symptoms. After plaque builds up, the first symptoms of carotid artery disease may be a stroke or a transient ischemic attack (TIA). A TIA is a small stroke that doesn't cause any lasting damage.

Symptoms of stroke and TIA include:

Exams and Tests

Your health care provider will perform a physical exam. Your provider may use a stethoscope to listen to the blood flow in your neck for an unusual sound called a bruit. This sound may be a sign of carotid artery disease.

Your provider also may find clots in the blood vessels of your eye. If you have had a stroke or TIA, a nervous system (neurological) exam will show other problems.

You may also have the following tests:

The following imaging tests may be used to examine the blood vessels in the neck and brain:

Treatment

Treatment options include:

You may have certain procedures to treat a narrowed or blocked carotid artery:

Outlook (Prognosis)


Possible Complications

Major complications of carotid artery disease are:

Transient ischemic attack: This occurs when a blot clot briefly blocks a blood vessel to the brain. It causes the same symptoms as stroke. Symptoms last only a few minutes to an hour or two, but no longer than 24 hours. A TIA does not cause lasting damage. TIAs are a warning sign that a stroke may happen in the future if nothing is done to prevent it.

Stroke: When the blood supply to the brain is partly or completely blocked, it causes a stroke. Most often, this happens when a blood clot blocks a blood vessel to the brain. A stroke can also occur when a blood vessel breaks open or leaks. Stokes can cause long-term brain damage or death.

When to Contact a Medical Professional

Go to the emergency room or call the local emergency number (such as 911) as soon as symptoms occur. The sooner you receive treatment, the better your chance for recovery. With a stroke, every second of delay can cause more brain injury.

Prevention

Here's what you can do to help prevent carotid artery disease and stroke:

References

Brott TG, Halperin JL, Abbara S, et al. American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, et al. 2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS guideline on the management of patients with extracranial carotid and vertebral artery disease: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American Stroke Association, American Association of Neuroscience Nurses, American Association of Neurological Surgeons, American College of Radiology, American Society of Neuroradiology, Congress of Neurological Surgeons, Society of Atherosclerosis Imaging and Prevention, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of NeuroInterventional Surgery, Society for Vascular Medicine, and Society for Vascular Surgery. Vasc Med. 2011;16:35-77. PMID: 23281092 www.ncbi.nlm.nih.gov/pubmed/23281092.

Meschia JF, Bushnell C, Boden-Albala B, et al. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014; 45:3754. PMID: 25355838 www.ncbi.nlm.nih.gov/pubmed/25355838.

Ricotta JJ, Ricotta JJ. Carotid artery disease. In: Cronenwett JL, Johnston KW, eds. Rutherford's Vascular Surgery. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 99.



Review Date: 8/13/2015
Reviewed By: Joseph V. Campellone, MD, Division of Neurology, Cooper University Hospital, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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