Carotid artery disease is a major cause of strokes (sometimes called “brain attacks”). A stroke can lead to life-changing disabilities or death.
At the Washington University and Barnes-Jewish Heart & Vascular Center, our vascular team can identify and treat carotid artery disease and prevent strokes. We often use minimally invasive methods to remove blockages and restore blood flow, even in high-risk patients over age 75.
What Is Carotid Artery Disease?
The carotid arteries, located on each side of the neck, are the main source of blood flow to the brain and face. They carry blood from the aorta in the chest into the brain through the base of the skull.
A healthy artery is open and allows ample blood flow to the brain. Blood flow can become partially or totally blocked by fatty material called plaque. A partial blockage of the artery is called carotid artery stenosis (narrowing).
As more plaque forms, the artery becomes narrower, and the walls become irregular, which can cause blood clots to form on the plaque. As narrowing increases, so does the risk of stroke.
Risk Factors for Carotid Artery Disease
Many of the factors that raise your risk of carotid artery stenosis are within your control. Carotid artery disease is more likely in people who have:
- high blood pressure or high cholesterol levels
- diabetes or insulin resistance
- family history of atherosclerosis (hardening of the arteries)
- overweight or obesity
- sedentary lifestyle
- smoking habit
Symptoms of Carotid Artery Disease
Many people do not have any symptoms of blocked carotid arteries. Some have a carotid bruit, a whooshing sound health care providers can hear through a stethoscope.
A stroke could be the first indication of carotid artery stenosis. Any blockage in the carotid artery can reduce the brain’s blood supply and lead to a stroke. A stroke can also happen if plaque or a blood clot breaks loose and travels to the brain.
If a blockage forms in a small blood vessel, you might experience a mini-stroke (transient ischemic attack, or TIA). A TIA is often a warning sign that a stroke may soon occur. If you have signs of a TIA, you should seek medical attention to find the cause of the problem.
Signs of a stroke or TIA include:
- dizziness or losing your balance
- headache that comes on suddenly and severely
- slurred speech
- sudden weakness, numbness or paralysis
- vision problems
If you think you could be having a stroke, call 911 immediately. Getting rapid treatment makes a big difference in your chances of making a full recovery.
Diagnosing Carotid Artery Disease
The Heart & Vascular Center performs many carotid ultrasounds and other tests every year, giving us deep expertise in interpreting the results. Our vascular laboratory is accredited by the Intersocietal Commission for the Accreditation of Vascular Laboratories (ICAVL).
To evaluate your carotid arteries, your doctor may order one or more of the following:
- ultrasound, which uses painless sound waves to measure the thickness of the carotid arteries and how fast blood flows through the arteries
- angiography, which uses X-rays and a special dye injected into the arteries to show blood flow
- computed tomographic angiography (CTA), which uses CT scan (X-rays and a computer) and dye to image carotid arteries and show evidence of prior stroke
- magnetic resonance angiography (MRA), which uses magnetic fields and dye to image carotid arteries and show evidence of prior stroke
Carotid Artery Disease Treatment
For mild carotid artery disease, medication may protect your health. Our vascular team prescribes medications to reduce clotting or dissolve an existing clot.
If your doctor diagnoses significant carotid stenosis, surgery may be the most appropriate therapy. Not all patients need surgery right away. Your doctors may recommend surgery if you have had a prior stroke or TIA or have severely blocked carotid arteries.
Your surgeon talks with you about the procedure best suited for you, which may include either open or minimally invasive surgery. Procedures include carotid endarterectomy, transcarotid artery revascularization (TCAR) and transfemoral carotid angioplasty and stenting (CAS). Learn more about our carotid artery treatment.
To make an appointment with a Washington University vascular specialist at Barnes-Jewish Hospital, call 314-273-7373.