carotid artery disease | Dr Raghu


The human body has two carotid arteries, on either side of the neck, that are responsible for carrying oxygen-rich blood to the brain and face. Plaque buildup in these arteries can lead to a condition called carotid artery disease.

Also known as carotid artery stenosis, the condition is characterized by narrow and/or stiff carotid arteries. That, in turn, restricts the flow of oxygen-rich blood to the brain and can result in a stroke or transient ischemic attack (TIA).

In this article, we’ll take a closer look at the cause, symptoms, and treatment of carotid artery disease. Let’s dive right in.

What Causes Carotid Artery Disease?

Carotid artery disease is caused by the narrowing of carotid arteries due to plaque buildup. Plaque is a mix of fat, cholesterol, cellular debris, and fibrous tissue that gets deposited on the walls of the carotid arteries, thus narrowing them and restricting blood supply to critical parts of the brain.

The narrowing of arteries due to plaque buildup is known as atherosclerosis. Common risk factors of atherosclerosis include:

  • A sedentary lifestyle
  • Pre-existing medical conditions, such as diabetes, hypertension, and obesity
  • A high-fat diet
  • A family history of heart disease
  • Smoking and alcohol consumption

Common Symptoms of Carotid Artery Disease

Before visiting a doctor, it’s crucial to have a clear idea of its symptoms. Unfortunately, a stroke is often the first symptom of the disease. It happens when a piece of plaque and/or blood clots break away from the carotid artery, enter one of the smaller arteries in the brain, and cut off blood supply to the brain.

A stroke results in the death of brain cells and can even lead to permanent paralysis and death. The most common symptoms of a stroke include:

  • Dizziness and fainting
  • Facial numbness
  • Disorientation
  • Slurred speech
  • Severe headache
  • Numbness or weakness in the limbs

If you experience a sudden onset of these symptoms, make sure you consult a carotid artery disease specialist right away. Even if these symptoms subside on their own and don’t result in a stroke, they could be indicators of an underlying health problem.

Diagnosis and Treatment of Carotid Artery Disease

Carotid artery disease is usually diagnosed only after a patient has had a stroke or TIA. The first thing a doctor will do is press a stethoscope on your neck to detect a murmur or whistling sound (bruit). It’s one of the most tell-tale signs of narrow carotid arteries.

Additionally, a doctor will use imaging scans, such as CT angiography and magnetic resonance angiography (MRA), to confirm their diagnosis. They can also use an ultrasound scan or cerebral angiography.

These tests are crucial for assessing the state of the carotid arteries and determining the stage of the disease. Carotid artery stenosis is usually categorized into three stages:

  • Mild – Less than 50% blockage
  • Moderate – 50 to 79% blockage
  • Severe – 80 to 99% blockage

Mention about carotid stent procedure and carotid endarterectomy – pros and cons 

The treatment of carotid artery stenosis depends on the stage where the condition is diagnosed. Mild to moderate cases can be treated with a combination of lifestyle changes and medications, such as blood thinners, beta-blockers, and statins.

In the case of severe carotid artery disease, patients often have to undergo a surgical procedure called carotid endarterectomy. A vascular surgeon or carotid artery stenosis specialist removes the plaque through an incision in the carotid artery and restores blood flow to the brain.

Timely diagnosis and treatment of carotid artery stenosis can improve a patient’s outlook and quality of life. If you’re at risk of developing the disease due to your medical history, lifestyle, or genetics, make sure you know what the symptoms are and what doctor treats carotid artery disease in your city or state.

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      Carotid artery disease is a condition that arises when the fat deposits accumulate and block the blood vessels that deliver blood to the brain. People with carotid artery disease are at higher risk of developing stroke. So, to determine the risk and prevent the associated complications, a procedure known as cerebral angiography is recommended.

      Cerebral angiography is a diagnostic procedure that uses X-rays to evaluate the blockage or any brain abnormalities in the carotid arteries (blood vessels in the brain and neck).

      When is cerebral angiography recommended?

      Cerebral angiography is recommended if the doctor suspects any of the following abnormalities within the brain:

      • An aneurysm
      • A dilated blood vessel in the brain
      • Brain tumour
      • Brain clot
      • Stroke

      It is also used to evaluate arteries in the head and neck before undergoing any surgery to provide additional information regarding any abnormalities that are not visible on other imaging tests, and as a minimally invasive procedure to treat vessel abnormalities.

      In some cases, it is done to determine the underlying cause of the following symptoms:

      • Severe headache
      • Memory loss
      • Dizziness
      • Blurred vision
      • Loss of balance or coordination
      • Weakness or numbness

      Before the procedure:

      Specific instructions are given before undergoing the procedure. These instructions may include:.

      • Any allergies
      • The use of current medicines, vitamins, and mineral supplement
      • The current medical conditions
      • Any food or dietary restrictions before the procedure.

      What happens in the procedure?

      Before initiating the procedure, the patient’s head is stabilized by using a strap, tape, or sandbags. Based on the age of the person, either local or general anaesthesia, is administered. Once the anaesthesia sets, the doctor will sterilize the groin region and make an incision. Under the guidance of X-rays, the catheter is passed into an artery in the neck.

      Once the catheter is placed in the correct position, the contrast dye is injected to highlight the blockage. After the X-rays are done, the catheter is removed, and the incision is closed.

      What to expect after the procedure?

      Once the procedure is done, the vitals are monitored in a recovery room. The person would be instructed to keep the leg straight if the catheter is administered through the groin region. Pain and inflammation at the site of incision are common, which can be relieved by applying ice packs and taking the prescribed medicines.

      What considerations should be taken after the test?

      Cerebral angiography is a diagnostic procedure, so there are not much considerations. However, following the below-given tips may ease the discomfort associated with the test:

      • Have a healthy and well-balanced diet.
      • Do not lift heavy weight for a few days or as suggested by the doctor.
      • Perform normal activities 8 to 12 hours after the procedure.

      Talk to the doctor:

      Call the doctor immediately on noticing any of the following symptoms:

      • Chest pain
      • Dizziness
      • Infection at the catheter site
      • Shortness of breath
      • Skin rash
      • Slurred speech
      • Vision problems
      • Numbness in the face, arms, or leg muscles

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          Dr. Raghu | Heart Specialist in Hyderabad
          Aster Prime Hospital, Plot No: 2, Mytri Vihar, Satyam Theatre Lane Nearest Metro Station: Ameerpet Metro (100 Mtrs), Telangana 500016

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