The carotid arteries are two major blood vessels located in the neck, which provide most of the blood supply to the brain. These arteries can develop deposits of plaque in their walls, which may lead to clogged arteries. As plaque deposits grow, a condition called atherosclerosis results. This condition causes the arteries to narrow (stenosis) and harden–decreasing blood flow to the brain.
If an emboli (a bit of matter foreign to the bloodstream) breaks off and travels to the brain, it can cause stroke, or "mini" stroke, also called a TIA, for transient ischemic attack.
About one-third of all strokes are caused by narrowing of the neck arteries. Stroke is the third highest cause of death and the number one cause of disability in the United States.
Family history, high blood pressure, high cholesterol, heart disease, diabetes, smoking, and obesity make some people susceptible to carotid artery disease.
The very first symptom of carotid blockage can be the stroke or mini-stroke itself. The symptoms listed below are common to both types of stroke, the difference being how long symptoms last–over 24 hours for a stroke (doing more permanent damage); a few minutes or hours for a "mini" stroke:
- Numbness in the arms or legs, especially on just one side of the body
- Drooping of one side of the face
- Difficulty speaking or understanding speech
- Sudden memory loss
- Difficulty seeing from one or both eyes
- Poor physical coordination
- Severe headache
However, carotid artery disease can have no symptoms, with the person still at risk for stroke. Sometimes the condition can be detected during a physical examination, when a stethoscope placed on the neck over the artery picks up a swishing sound.
If our physicians suspect narrowed carotid arteries, they administer tests to see if treatment is necessary. The test most commonly used is a duplex ultrasound. Magnetic resonance angiogram (MRA), computed tomography angiogram (CTA) and cerebral angiogram are done in select cases.
- Carotid Endarterectomy (CEA): Surgical removal of built-up plaque restores blood flow. An open surgery is a preferred treatment option for carotid artery disease.
MINIMALLY INVASIVE TECHNIQUES
- Carotid Angioplasty and Stenting: Guided to the blockage by a catheter, a balloon opens, pressing plaque against artery walls and restoring blood flow. A small metal tube (stent) is left to reinforce the artery and maintain the opening.
For more information or to make an appointment with a vascular surgeon at Mount Sinai Beth Israel, click here to fill out an appointment scheduling form. A staff member will get back to you within 48 hours to schedule an appointment.