Carotid Artery Stenosis
(Internal Carotid Artery Stenosis; Carotid Artery Disease)
Carotid artery stenosis occurs when the carotid arteries narrow. The carotid arteries are major arteries found on each side of the neck. They supply blood from the heart to the brain.
This condition is a major risk factor for ischemic stroke. Ischemic stroke is when blood flow to the brain is blocked due to blood clots.
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Carotid artery stenosis is caused by the build-up of plaque along the lining of the arteries. This build-up is known as atherosclerosis. Plaque is made up of cholesterol, fat, and other substances.
Carotid artery stenosis is more common in men aged 75 or younger and women aged 75 or older. Risk factors include:
There are usually no symptoms. Tell your doctor if you have symptoms of a stroke or a transient ischemic attack (TIA or mini-stroke). This is a warning sign that you may have carotid artery stenosis. Symptoms may include:
- Blindness, blurry or dim vision
- Weakness, numbness, or tingling of the face, arm, leg, or one side of the body
- Difficulty speaking or understanding words
- Lightheadedness, unsteadiness of gait, or falling
- Trouble with balance or coordination
- Loss of consciousness
- Nausea or vomiting
- Sudden confusion or loss of memory
You will be asked about your symptoms and medical history. A physical exam will be done.
Imaging tests may include:
- Carotid ultrasonography
- Computer tomography angiography (CTA)
- Magnetic resonance angiography (MRA)
The goal of treatment is to prevent carotid artery stenosis from causing inadequate blood flow to the brain or causing a stroke. Treatment will depend on:
- The severity of your condition
- Your symptoms
Talk with your doctor about the best treatment plan for you. Treatment options include:
Medication and Lifestyle Changes
If there are no symptoms and if plaque build-up is not severe, medications like aspirin may be given to help prevent a stroke from occurring. Lifestyle changes are also an important part of treatment. Some actions you can take to reduce your risk of stroke include:
Surgery may be needed if the arteries have severe plaque build-up. One kind of surgery is called carotid endarterectomy. This involves opening the artery and cleaning the plaque from it. Another surgery that may be done is carotid angioplasty and stenting. In this surgery, a balloon is inserted into the artery to widen it. Then a metal mesh, called a stent, is inserted to keep the artery open so that blood can flow freely.
To help reduce your chance of getting carotid artery stenosis, you will need to decrease the risk factors that you can control. For example, you can reduce your cholesterol, blood pressure, and weight. Here are some steps to decrease these risk factors:
- Exercise regularly.
- Eat more fruits and vegetables. Limit dietary salt and fat.
- If you smoke, talk to your doctor about ways to quit.
- If you drink alcohol, do so only in moderation. This means having no more than 2 drinks per day if you are a man, and no more than 1 drink per day if you are woman.
- Maintain a healthy weight.
- Keep your blood pressure in a safe range. Follow your doctor's recommendations if you have high blood pressure.
- Keep other conditions under control. This includes high cholesterol and diabetes.
American Heart Association
National Stroke Association
Heart and Stroke Foundation of Canada
Buckley L, Schub T. Carotid stenosis. EBSCO Nursing Reference Center website. Available at: http://www.ebscohost.com/nursing/products/nursing-reference-center. Accessed March 1, 2018
Carotid artery stenosis. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T116329/Carotid-artery-stenosis. Updated December 29, 2015. Accessed March 1, 2018.
Last reviewed March 2018 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC Last Updated: 5/2/2014