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Carotid Artery Disease, Carotid Artery Stenosis
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Definition
Cardiovascular disease refers to disease or problems with the cardiovascular system. The cardiovascular system has two main components: the heart and the blood vessels. There are many terms that are associated with cardiovascular disease. Some of the terms used include coronary artery disease, coronary heart disease, heart disease, and peripheral vascular disease.
Description | Treatment Options | John Muir Health Capabilities | Related Links
Description
What is Carotid Artery Stenosis?
Carotid artery stenosis is the narrowing of the carotid arteries. These are the main arteries in the neck that supply blood to the brain. Carotid artery stenosis, also called carotid artery disease, is a major risk factor for stroke. The most common form of stroke is usually caused by a blood clot that plugs an artery.
Treatment Options
How does Carotid Disease or Stenosis develop?
The carotid arteries are located in the neck area with branches on left and right side. The carotid arteries supply the large, front part of the brain, where thinking, speech, personality, sensory and motor functions reside. Like the blood vessels in other areas of the body (heart, legs, kidneys), the carotid arteries can develop atherosclerosis. Atherosclerosis is the build-up of fat and cholesterol deposits, called plaque. These deposits begin to line the inside of the arteries. Over time, the build-up causes narrowing of the artery and decreases blood flow to the brain. This can lead to a stroke. Common causes of a stroke are:
- The artery becomes extremely narrowed
- A piece of plaque breaks off and travels to the smaller arteries of the brain
- A blood clot forms and blocks a narrowed artery
- Carotid artery disease may not have symptoms. During a check up, a doctor will listen to the arteries in the neck with a stethoscope. An abnormal rushing sound may indicate narrowing in the artery. The abnormal sound is not always present when blockages are present.
John Muir Health Capabilities
How is carotid artery stenosis treated? If a narrowing is suspected, the doctor will order an ultrasound of the carotid arteries. This test uses sound waves to check blood flow in the neck region. A carotid ultrasound is very similar to a cardiac echo. Both use sound waves to evaluate blood flow. The carotid ultra sound looks specifically at flow through the carotid arteries. If the ultrasound indicates that there is narrowing, the doctor will order an angiogram.
A carotid angiogram (carotid arteriogram) is an imaging procedure that involves inserting a catheter into a blood vessel in the arm or leg, and guiding it to the carotid arteries. Using special x-ray machine to take moving pictures, a substance called contrast dye is injected through the catheter. The contrast outlines the blood vessels of the head and neck area. The doctor will evaluate the degree of stenosis and decide upon a treatment plan.
The most common treatment to correct the narrowing in the carotid artery is called carotid endarterectomy. This is a surgical treatment for carotid artery disease. In surgery, an incision is made in the neck, at the location of the blockage. The surgeon opens the carotid artery and removes the plaque and diseased portions of the artery. Then, the artery is sewn back together to allow blood flow to the brain.
Carotid angioplasty may be another treatment option. The procedure is very similar to the angioplasty and stent procedures done in the heart arteries. This treatment uses balloons and/or stents to open a narrowed artery. As a procedure, it is performed just like a cardiac angioplasty except the target arteries are in the neck. A specially designed catheter (tube) with an umbrella tip is placed over a guide wire. Using special x-rays, the doctor guides the catheter to the area of narrowing in the carotid artery. Once in place, a small balloon tip is inflated for a few seconds to enlarge the artery. A very tiny, spring-like device called a stent may be use to hold the artery open.
The stent acts like a scaffold to provide support inside the artery. The stent stays in place permanently. After several weeks, your artery heals around the stent.
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