The carotid arteries are two blood vessels in the front of the neck that help to supply blood to the brain. The blood provides oxygen and nutrients to the brain. If the carotid arteries become diseased, narrowed (also known as stenotic) or blocked an embolic stroke can occur. This event is when the artery completely occludes or a piece of debris or clot is carried to a blood vessel in the brain and blocks any further flow. The result can be a stroke. Strokes can be debilitating and many times the damage is permanent.
Risk Factors for Carotid Artery Disease and Stroke
Atherosclerosis: a build up of fats and cholesterol along the artery walls, known as plaque. Genetics: inherited conditions that affect the body’s blood vessels.
Aging: the arteries become stiffer and lined with plaque as we get older. Trauma: can damage or weaken the walls of arteries. Inflammation: any condition that causes a reaction in the vessel wall, such as radiation treatments. Hypertension: high blood pressure can damage the wall and stimulate atherosclerosis formation. Smoking: can damage the lining of any artery, as well as make arterial disease occur at a faster rate.
Testing for Carotid Artery Disease
Ultrasound: uses sound waves to estimate the amount of narrowing. CT angiogram: uses radiation and IV contrast to measure the narrowing. Magnetic Resonance Imaging: (MRI/MRA) uses magnetic imaging to measure the amount of stenosis. Arteriogram: this test is invasive and uses IV contrast but can sometimes be used to stretch, angioplasty, and stent the artery.
Treatment
The treatment for symptomatic carotid arteries, patients who are having ministrokes or TIAs (transient ischemic attacks) is either a carotid endartectomy or an angioplasty and stent placement. An endartectomy is an operation which opens the artery and the plaque is carefully removed. This procedure is also recommended in asymptomatic patients with a narrowing of 75 % or more. The purpose of any intervention on the carotid artery is to prevent a stroke from occurring or recurring.