Carotid Artery Stenosis

Causes

Carotid artery stenosis is caused by the build-up 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

Risk Factors

Carotid artery stenosis is more common in men and people over 60 years old. Other things that raise the risk are:

• Diabetes
• High blood pressure
• Smoking
• Problems with blood fat levels, such as:
  • High cholesterol
  • High triglycerides
• Narrowing of other arteries, such as:
  • Coronary artery disease—affects heart vessels
  • Peripheral artery disease (PAD)—affects leg vessels
• Aortic aneurysm—a weak, bulging vessel from the heart

Symptoms

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, blurry or dim vision
• Weakness, numbness, or tingling of the face, arm, leg, or one side of the body
• Problems speaking
• Lightheadedness
• Problems with balance or falling
• Loss of consciousness
• Nausea or vomiting
• Problems with thinking, understanding, or memory

Diagnosis

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:

• Carotid ultrasonography
• Computer tomography angiography (CTA)
• Magnetic resonance angiography (MRA)

Treatment

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 such as high blood pressure and diabetes—if present
• Lifestyle changes such as:
  • Quitting smoking
  • A healthful diet .
  • Regular physical activity .

For severe plaque build-up, surgery may be needed, such as:

• Carotid endarterectomy—to clean the plaque from the artery
• Carotid angioplasty and stenting—a stent is inserted to keep the artery open

Prevention

There are no guidelines to prevent carotid artery stenosis. However, certain risks may be lowered by:

• Regular physical activity
• 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. This includes high cholesterol, high blood pressure, and diabetes