Carotid Artery Stenosis
(Internal Carotid Artery Stenosis; Carotid Artery Disease)
Carotid artery stenosis is when the carotid arteries narrow. The carotid arteries are blood vessels on each side of the neck. They supply blood from the heart to the brain.
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Carotid artery stenosis is caused by the buildup of plaque in the arteries. This build-up is called atherosclerosis. Plaque is made of cholesterol, fat, and other substances.
Less common causes are problems in the carotid artery, such as:
- An injury or tear
- Arteritis (inflammation)
- A blood clot
- A tumor
Carotid artery stenosis is more common in men and people over 60 years of age. Other things that raise the risk are:
- High blood pressure
- Problems with blood fat levels, such as:
- Narrowing of other arteries, such as:
- Aortic aneurysm—a weak, bulging vessel from the heart
There are usually no symptoms. When symptoms happen, they may be those of a stroke or a transient ischemic attack (TIA or mini-stroke). Symptoms may be:
- Short-term loss of sight in one eye or dim vision
- Weakness, numbness, or tingling of the face, arm, leg, or one side of the body
- Face drooping
- Problems with balance or falling
- Loss of consciousness
- Nausea or vomiting
- Problems with speaking, thinking, understanding, or memory
The doctor will ask about symptoms and past health. A physical exam will be done.
Imaging tests will diagnose blood vessel problems. They may include:
The goal of treatment is to improve blood flow to the brain and prevent a stroke. Treatment depends on how severe the condition is. It also depends on if there are symptoms.
Treatment options may be:
- Medicines to:
- Thin blood
- Lower cholesterol
- Manage other conditions a person may have, such as high blood pressure and diabetes
- Lifestyle changes such as:
Surgery may be needed for severe plaque buildup. Options are:
- Carotid endarterectomy—cleaning the plaque from the artery
- Carotid angioplasty and stenting—inserting a stent to keep the artery open
There are no guidelines to prevent carotid artery stenosis. A person may be able to lower their risk of having it by:
- Working out regularly
- Eating more fruits and vegetables and eating less salt and fat
- Not smoking
- Not drinking alcohol, or drinking it in moderation—this means:
- No more than 2 drinks per day for men
- No more than 1 drink per day for women
- Keeping other conditions under control such as high cholesterol, high blood pressure, and diabetes
- Baiu, I., Stern, J.R. Carotid artery endarterectomy. JAMA, 2020; 324 (1): 110.
- Carotid artery stenosis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/carotid-artery-stenosis.
- Carotid artery stenosis. RadiologyInfo website. Available at: https://www.radiologyinfo.org/en/info/carotidstenosis.
- Carotid stenosis. EBSCO Nursing Reference Center Plus website. Available at: http://www.ebscohost.com/nursing/products/nursing-reference-center-plus.
- Nicole Meregian, PA
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