About Carotid Artery Disease

Carotid artery disease results from the buildup of fatty material (plaque) inside the major blood vessels along the front of the neck. These blood vessels, called the carotid arteries, are the main pathways for blood to flow from the heart to the brain. When these arteries are blocked, a stroke can occur.

What is a stroke?

A stroke occurs when cells in the brain are damaged or destroyed due to a lack of oxygen when blood flow to the brain is suddenly stopped. This can happen when plaque blocks the flow of blood in the carotid arteries or when pieces of plaque break loose and block smaller blood vessels within the brain. Depending on where the blockage occurs, the damage resulting from a stroke can affect speech, vision, movement, and other abilities. Stroke can also result in death or disability.

For most people, the first sign of a carotid blockage is a major stroke that happens without warning. However, there are symptoms that can signal the presence of carotid artery disease and the risk of stroke, including:

• Weakness, tingling, or paralysis in the arms, legs, or face
• Trouble swallowing
• Blurred vision or temporary loss of eyesight
• Sudden severe headache with no known cause
• Dizziness, confusion, or fainting

Carotid artery disease is associated with many of the same risk factors as stroke, including:

• Family history of stroke
• Family history of coronary or carotid artery disease
• Advanced age (over 70 years)
• Plaque buildup (atherosclerosis) in other areas of the body
• High blood pressure
• Diabetes
• Smoking
• Irregular heartbeat (atrial fibrillation)

Diagnosis

A doctor can detect carotid artery blockage by listening to the arteries in your neck with a stethoscope. A “swooshing” sound, called a bruit (BROO-ee), may indicate you have carotid artery disease. The diagnosis can be confirmed with an ultrasound test. If a severe blockage is present, treatment may be necessary to restore blood flow to the brain.

Depending on the patient, carotid artery disease has traditionally been managed with lifestyle changes, medication, and/or a surgical procedure called carotid endarterectomy (CEA), which is the standard surgical treatment for carotid blockages today. An alternative procedure called carotid artery stenting is also available for some patients.

Carotid artery stenting procedures are currently approved for patients with or without symptoms who are at high risk if they undergo CEA with general anesthesia. In the ACT I study, this kind of procedure is now being investigated for use in patients with carotid artery disease who are not at high surgical risk.

 

1. American Heart Association. Heart Disease and Stroke Statistics—2006 Update. Dallas, Tex: American Heart Association; 2006.

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