Carotid artery stenosis is a narrowing or blockage of the carotid arteries - major blood vessels in the neck that supply oxygen-rich blood to the brain. This condition is most commonly caused by atherosclerosis, a buildup of plaque consisting of fat, cholesterol, calcium, and other substances. As the arteries narrow, the risk of stroke significantly increases, making early diagnosis and management critical.
Causes of Carotid Artery Stenosis
Carotid artery stenosis develops over time due to plaque accumulation. Risk factors include:
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Increasing age
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Smoking
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High blood pressure
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High cholesterol
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Diabetes
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Obesity
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Sedentary lifestyle
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Family history of atherosclerosis or stroke
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Cardiovascular disease
In rare cases, the condition may also result from trauma, arterial dissection, or inflammatory vessel diseases.
Symptoms of Carotid Artery Stenosis
Many patients with carotid artery stenosis may be asymptomatic until the condition becomes severe. When symptoms do occur, they may present as transient ischemic attacks (TIAs), often referred to as “mini-strokes.” These may include:
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Sudden numbness or weakness in the face or limbs, often on one side of the body
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Difficulty speaking or understanding speech
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Sudden vision loss or blurring in one or both eyes
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Dizziness or loss of balance
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Sudden severe headache without known cause
These symptoms are serious warning signs and should prompt immediate medical attention.
Diagnosis of Carotid Artery Stenosis
Diagnosis typically involves a combination of physical examination and imaging tests, which may include:
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Carotid bruit detection during physical exam
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Carotid duplex ultrasound
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CT angiography (CTA)
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Magnetic resonance angiography (MRA)
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Cerebral angiogram (in select cases)
Treatment of Carotid Artery Stenosis
Treatment aims to reduce stroke risk by controlling underlying conditions and, when necessary, restoring proper blood flow. Options include:
Lifestyle Changes
Patients are encouraged to adopt heart-healthy habits, including:
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Smoking cessation
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Managing blood pressure and cholesterol
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Maintaining a healthy diet and weight
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Regular physical activity
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Blood sugar control in diabetic patients
Medications
Medical therapy often includes:
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Antiplatelet agents (e.g., aspirin, clopidogrel) to reduce clot formation
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Statins to lower cholesterol
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Antihypertensive medications
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Diabetes management as needed
Surgical Interventions
In cases of significant blockage or when symptoms are present, surgical treatment may be necessary:
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Carotid Endarterectomy (CEA): Surgical removal of plaque from the artery wall
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Carotid Artery Stenting (CAS): A minimally invasive procedure using a balloon and stent to open the artery
Your vascular specialist will determine the most appropriate option based on your overall health and the severity of the stenosis.
Risks of Surgery for Carotid Artery Stenosis
Though generally safe, surgical procedures carry certain risks, particularly in older or higher-risk patients. Potential complications include:
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Stroke during or after the procedure
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Heart attack
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Bleeding or infection at the surgical site
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Nerve injury
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Restenosis (re-narrowing of the artery)
Recovery from Carotid Surgery
Most patients recover well with appropriate follow-up. Activity restrictions and wound care instructions will be provided based on the type of procedure performed. Ongoing lifestyle modifications and medication adherence are essential to prevent recurrence and protect brain health.