Carotid Artery Stenosis

Carotid artery stenosis, also called carotid artery disease, is a blockage within the blood vessels that lead to your brain and head. Without a sufficient blood supply, your brain will become deprived of oxygen. This can lead to a stroke, the most common cause of death in the United States. At The University of Kansas Health System, we offer comprehensive care for carotid artery stenosis, from diagnosis to advanced treatment and prevention.

The carotid arteries are located in the neck on each side of the windpipe. They supply the brain with oxygenated blood. These arteries can become narrowed or clogged by fatty or cholesterol deposits called plaque. The clogging of these arteries creates the blockage that is carotid artery stenosis.

When the carotid arteries are clogged by these deposits, they become stiff. The plaque buildup reduces the amount of space where blood can flow, which limits the ability of your carotid arteries to deliver vital oxygen and nutrients to the brain.

A carotid artery blockage can reduce or cut off the blood supply to the brain. It also can result in small pieces (emboli) of the blockage breaking off and blocking other arteries to the brain or eye. Carotid artery stenosis causes up to a third of all strokes in the United States. Stroke is a primary cause of disability as well, and can cause permanent brain damage.

Most people with carotid artery stenosis have no symptoms. If you are at risk, your doctor should make sure to listen to the carotid arteries in your neck with a stethoscope during your regular checkups. If the doctor hears a swishing sound in the artery, called a bruit, you may need further tests.

One of the signs of a stroke is a transient ischemic attack or TIA. These symptoms can be very short or last as long as 24 hours. You should seek emergency help if you experience:

• Speech problems such as slurring, difficulty talking or understanding others
• Sudden weakness or numbness of one side of the face, an arm or leg
• Vision loss in one eye

You are at greater risk for carotid artery blockage if you have atherosclerosis. Atherosclerosis is when the blood vessels become restricted or blocked by fatty or cholesterol deposits. You also are at greater risk for developing carotid artery stenosis if you have peripheral artery disease (PAD).

Other risk factors of carotid artery stenosis include:

• Age and gender: Men are at higher risk before age 75; women are at higher risk after 75
• Diabetes
• Family history of this problem
• High blood pressure (hypertension)
• High cholesterol
• Obesity
• Race or ethnicity: All are at risk, though African American and Hispanic people are at greater risk
• Sedentary lifestyle
• Tobacco use: Smoking increases your risk dramatically

To diagnose carotid artery stenosis, your doctor will perform a full physical evaluation, including taking a complete medical history. As part of this exam, your doctor will listen for the distinctive sound within the carotid artery that indicates a narrowed artery. Other aspects of your health your doctor may examine include your physical and mental responses, including speech and memory evaluations.

Your doctor may recommend additional tests to check for carotid artery stenosis:

• A CT scan or MRI can check for abnormalities or show signs of a stroke.
• An ultrasound can measure blood flow and blood pressure within the carotid arteries.

The University of Kansas Health System offers advanced vascular disease imaging tests to ensure the most accurate diagnosis so we can recommend the best treatment options for each individual.

The treatment goal for carotid artery stenosis is to reduce the arterial blockage and prevent a stroke. Your doctor will decide on the best treatment or combination of treatments based on the extent of the existing blockage.

Making certain lifestyle changes can help slow down the progress of atherosclerosis:

• Eating a heart-healthy diet
• Getting regular exercise
• Maintaining a healthy weight
• Quitting smoking
• Reducing your salt intake

Your doctor may suggest medications to help lower your cholesterol or control your blood pressure. If blood clots are a concern, your doctor may also recommend taking a low dose of aspirin every day or prescribe a blood thinning medication.

If your carotid artery blockage is severe, your doctor may recommend removing the plaque to restore blood flow to the head and brain. At The University of Kansas Health System, we offer a wide range of options for vascular surgery, including surgery for high-risk patients.