What you need to know about carotid artery disease

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While most people have heard of strokes, many don't know the importance of your carotid artery in causing a stroke.  It's important for everyone to understand the signs of carotid artery disease and how to reduce the risk of it leading to a stroke.

What are your carotid arteries?

Your carotid arteries are blood vessels in your neck that carry blood up to your brain and face.  Your common carotid arteries enter your neck on both the left and right side before splitting into an internal and external carotid. The internal carotid is the most important as this is the one that carries blood to your brain.

Carotid artery disease

Sometimes atherosclerosis occurs in the carotid arteries, especially at the bifurcation or the point where the common carotid divides into the internal and external carotids.  Atherosclerosis means that a potentially dangerous plaque has formed on the artery wall.  Plaque is a sticky material made of fat and calcium which hardens the arteries and can block the flow of blood.  This narrowing is sometimes called a carotid artery stenosis, meaning that the carotid artery has narrowed significantly.

Carotid artery disease and stroke

Sometimes the plaque on the carotid arteries becomes particularly large or brittle.  In this instance, a piece can break off.  If it travels up the internal carotid artery into the brain it will cut off blood flow to part of the brain, causing a transient ischaemic attack (TIA) or a stroke.  The initial symptoms of both are similar and can range from numbness and paralysis in part of the body to difficulty speaking to dizziness and vision changes. In a TIA  these symptoms resolve completely within 24 hours as no permanent damage has been caused. However, strokes can be catastrophic or even fatal due to the permanent damage caused.

Warning signs of carotid artery disease

Many people will be unaware they have carotid artery disease until they have a TIA or stroke.  You may have the possibility picked up by a vascular surgeon, like Timothy Wagner, during an examination when they hear a carotid bruit with their stethoscope, which is the sound of turbulent flow through your carotid arteries. Your vascular surgeon may request you have medical imaging such as an ultrasound, CT or MRI to inspect your carotid arteries and gain more information about any narrowing of your carotid arteries.

Treatment of carotid artery disease

Treatment can be either non-surgical or surgical.  Your vascular surgeon may suggest non-surgical interventions such as weight loss, exercise or medication to stabilise any plaques and reduce your blood pressure.  Alternatively, surgery such as a carotid endarterectomy may be suggested, which involves removing the plaque from the inside of the artery.  Sometimes a stent may be placed to minimise the plaque and keep your carotids open.

Reducing the risk

Your risk of carotid artery disease increases if you have a family member who has had atherosclerosis.  It also increases as you age and if you're male.  These are known as non-modifiable risk factors, as there's nothing you can do to change them.  Modifiable risk factors for carotid artery disease are ones which you can change, and include smoking, having high blood pressure or high cholesterol as well as diabetes.