Carotid Artery Stenosis

What is a Carotid Artery Stenosis?

Carotid Artery Stenosis is a condition where the carotid arteries, the major blood vessels that supply blood to the brain, become narrowed or blocked due to a buildup of plaque (atherosclerosis). This narrowing can raise the risk of stroke and decrease blood supply to the brain.

Common risk factors include high blood pressure, smoking, diabetes, high cholesterol, and aging. Early detection and management through lifestyle changes, medication, or surgical procedures like carotid endarterectomy or stenting are crucial to prevent complications.

To ascertain the existence, location, and degree of stenosis, your doctor may employ cerebral angiography, magnetic resonance angiography (MRA), CT angiography (CTA), or carotid ultrasound. Vascular stenting and angioplasty are two possible treatments to enhance or restore blood flow. In severe cases, surgery can be recommended.
The obstruction raises the chance of having a stroke. A stroke is a medical emergency that happens when there is little to no blood flow to the brain.

Brain cells start to die minutes after a stroke because the brain isn’t getting enough oxygen. In the United States, stroke is a major cause of mortality and disability.

Often, carotid artery disease progresses slowly. A transient ischemic attack (TIA) or stroke could be the first indication of the illness. A transient embolism (TIA) is a brain haemorrhage.

Carotid artery disease is often treated with medication, lifestyle modifications, and occasionally surgery.

What is Carotid Artery Stenosis?

The condition known as carotid artery stenosis results from blockage of the carotid artery, which is the main artery on either side of your neck. The blockage is composed of deposits of fatty cholesterol, or plaque. A plaque buildup in your carotid artery increases your risk of stroke by obstructing the regular blood flow through it. The term for plaque accumulation is atherosclerosis.

Your neck is made up of two carotid arteries, one on each side. Your brain, face, and head receive blood flow from these large arteries. These arteries are open and smooth in a healthy state, similar to a clear pipe that permits fluid to pass freely through it without obstruction. The network of tubes that make up your body’s circulatory system distributes blood, which contains oxygen and nutrients, to every region of your body.

Either one of the two neck arteries, or both, may develop carotid artery stenosis. Without treatment, this illness may get worse over time and result in a stroke with serious consequences that may even be fatal.

A narrowing in the major arteries on either side of the neck is called carotid artery stenosis. The brain, face, and head are supplied with blood by these arteries. Atherosclerosis, or a buildup of plaque inside the arteries, is typically the cause of the constriction. Stenosis has the potential to progress to total arterial blockage over time.

Age, smoking, high blood pressure, diabetes, obesity, and an inactive lifestyle are risk factors for carotid artery stenosis.

It is possible for some patients with carotid artery stenosis to feel lightheaded, faint, or have impaired vision. These could be indicators of insufficient blood flow to the brain. Often, a transient ischemic attack (TIA) or stroke is the initial symptom. If atherosclerosis narrows an artery, a tiny blood clot may form in the affected area. The clot can come loose and enter the brain. Once there, it has the potential to obstruct a smaller artery that is essential to the brain’s survival.

Similar symptoms can be found in both TIAs and strokes, including headaches, impaired vision, difficulties speaking, paralysis or numbness on one side of the body, and trouble reacting to others. Usually short-lived, a TIA causes no long-term harm. It results from a tiny artery that is momentarily blocked. This is frequently a red flag. A stroke frequently results in a portion of the brain suffering permanent damage from a lack of blood flow. This may cause death or a moderate-to-severe disability.

Causes of Carotid Artery Stenosis

Carotid artery disease is caused by the development of plaques, or fatty deposits, in the arteries that provide blood to the cerebral areas. Plaques are clumps that form in the artery and include fat, cholesterol, and blood cells. Atherosclerosis is the term for this process.

Plaque blockage causes the carotid arteries to narrow. The brain has difficulty getting oxygen and nutrients when there is a blockage in the carotid arteries.

Over time, some variables may raise your risk of acquiring this condition. You have control over certain of these variables. Some exacerbate and add to other factors.

• They are consuming tobacco goods and smoking.
• Being overweight.
• An inactive way of life.
• High blood pressure (Hypertension)
• High cholesterol.
• Diabetes.
• Years old.

A buildup of plaques, or fatty deposits, in the arteries supplying blood to the brain is the cause of cerebral artery disease. Plaques are collections of fat, cholesterol, and blood cells that develop in the artery. This process is known as atherosclerosis.

Plaque blockage causes the carotid arteries to narrow. The brain has difficulty getting oxygen and nutrients when there is a blockage in the carotid arteries.

Symptoms of Carotid Artery Stenosis

Carotid artery stenosis can cause a stroke. The kind of stroke that usually happens from carotid stenosis is caused by pieces of plaque (or platelets that form on plaque) that travel to your brain. An “ischemic” stroke cuts off blood supply to a portion of your brain. When this obstruction is irreversible, your neurons, or brain cells, begin to die.

Carotid artery disease frequently exhibits no symptoms in its early stages. The illness cannot be noticeable until it gets severe enough to cause a blood shortage in the brain, which could result in a TIA or stroke.

Symptoms of a stroke, or TIA, include:

• sudden weakness or numbness in the limbs or face, usually limited to one side of the body.
• Sudden trouble speaking and understanding speech.
• Difficulty seeing in one or both eyes.
• Sudden dizziness or loss of balance.
• Sudden, severe headache with no known cause.

Strokes can be caused by carotid artery stenosis. The type of stroke that typically results from carotid stenosis involves the passage of plaque fragments, or platelets, that aggregate on plaque into the brain. A “ischemic” stroke occurs when a blood vessel carrying blood towards the brain is blocked or interrupted. The permanent obstruction causes the neurons in your brain to begin to die.

A transient ischemic attack (TIA) is akin to a “mini-stroke,” when a tiny brain artery becomes temporarily blocked due to the accumulation of plaque and/or platelets. A TIA frequently occurs before an ischemic stroke. To stop cell death in these cases, it’s critical to get treatment as soon as feasible.

The following are examples of TIA, or stroke symptoms:

• one side of your face droops.
• slurred speech or difficulty articulating ideas and speaking to others.
• experiencing the sensation of a dark shadow covering your field of vision while losing vision in one eye.
• losing sensation in a particular body part.
• experiencing weakness and loss of muscular mass on one side of the body.
• You might not have any symptoms if your carotid artery stenosis hasn’t resulted in a stroke.

How is Carotid Artery Stenosis classified?

Your doctor will check to see if you have the disease, how big it is, and where it is located throughout the diagnosing procedure. There are three main classifications for carotid artery stenosis: mild, moderate, and severe. A blockage of less than 50% is considered moderate. This indicates that the blockage in your artery is less than 50%.

A moderate blockage is between 50% and 79%. The most severe classification involves having the majority of your artery blocked — from 80% to 99%.

Diagnosis

A diagnosis of carotid artery stenosis is frequently made following the onset of stroke symptoms. Your doctor may detect carotid artery stenosis as a result of the symptoms, which urge a comprehensive examination for any kind of blockage. This issue can also be identified when your healthcare professional uses a stethoscope to examine your neck and detects an unusual sound, such as a bruit (whistling sound) or murmur. To determine the extent and location of the blockage and to confirm a diagnosis of carotid artery stenosis, healthcare professionals use a number of tests. These examinations may consist of:

Ultrasound:

Also known as a duplex ultrasound, this kind of examination creates a picture of the inside architecture of your body using sound waves. An ultrasound is a test performed on top of your skin that causes no pain. Using an ultrasound, you may observe how blood flows through your arteries and identify any areas where they might be constricted or obstructed.

Computed tomography angiography (CTA):

Your healthcare practitioner can get a close-up look at your carotid arteries by using a CT scanner, which utilizes X-rays to provide a detailed image of your inside organs. A dye is put into your circulation during this examination to assist highlight any obstructions on the pictures. People with pacemakers or stents from other diseases may be subjected to this test.

Cerebral angiography:

For this kind of diagnostic examination, a catheter is used in a minimally invasive procedure to enter your arteries and examine the blockage up close. In order to observe the complexities of your arteries, your doctor will also inject contrast material straight into your arteries during this procedure.

Magnetic resonance angiography (MRA):

Like a CT scan, but without X-rays, this test gives you smooth pictures of your arteries. The imaging test is noninvasive.

What is the Treatment for Carotid Artery Stenosis?

Stopping the disease’s progression is the primary objective of treatment for carotid artery stenosis. Making lifestyle changes, such as eating a balanced diet, exercising, and quitting smoking, is the first step in this process. In addition to drugs that decrease blood pressure and cholesterol, a baby may be given a daily dose of aspirin.

A surgical treatment known as a carotid endarterectomy may be used by the doctor to remove the plaque from the carotid artery through an incision in more severe cases or cases that are causing symptoms of a stroke or TIA. As an alternative, your surgeon might insert a stent by first puncturing the blocked artery with a big needle.

By doing this, the artery will enlarge to its appropriate size and the plaque will be trapped between the stent and the wall, preventing blood flow. The optimum course of action for each patient requiring treatment for carotid disease is decided by a vascular surgeon or specialist.

Because surgery and intervention are risky procedures, not all cases of carotid stenosis require them. Only when the dangers of severe stenosis and/or stroke surpass the risks of the surgery do surgeons advise people to have it done.

Prognosis

If carotid artery stenosis is not identified and treated promptly, it may become dangerous. A stroke caused by this disease may result in death or permanent disability. It is crucial to be aware of the symptoms of a stroke and to take prompt action if you or someone else exhibits them.

When carotid artery stenosis is treated promptly, it can save lives. The results of angioplasty and surgery are good when required. After only one night in the hospital, the majority of patients recover extremely fast.

Conclusion

Your chance of getting carotid artery stenosis rises with age. Maintaining a healthy lifestyle is the primary way to prevent this disorder and its complications, such as a stroke. Healthy living includes things like exercising, eating well, and quitting smoking.

Schedule routine follow-up consultations with both your vascular specialist and general care physician. Discuss with your doctor how to maintain the health of your heart and circulatory system as a whole.