Through our subspecialized Vascular Program at Hoag’s Jeffrey M. Carlton Heart & Vascular Institute, Orange County residents can receive world-class care close to home. Our team of vascular specialists utilizes the latest advancements in medicine to provide the cutting-edge care you need to stop vascular disease in its tracks. From Yorba Linda to Long Beach, Tustin to Ladera Ranch, Orange County trusts Hoag for next-generation vascular treatment and care.
Read on for what you need to know about Carotid Artery Disease, including symptoms, causes and risk factors. And remember: if you need treatment for carotid artery disease in Orange County, there’s no place like Hoag. Contact us today through our online form or by calling 949-764-5871.
Carotid artery disease is a serious medical condition where the carotid arteries, the blood vessels which supply oxygen-rich blood to the brain, become blocked or narrowed. Carotid artery disease is not to be confused with coronary artery disease (CAD) in which the coronary arteries are blocked or narrowed, reducing blood flow to the heart. Learn more about coronary artery disease here.
Normally, oxygen-rich blood freely passes through the carotid arteries to vital tissues within the brain. However, calcium and cholesterol, in a process known as atherosclerosis, can form into a substance known as plaque. Plaque deposits can form within a blood vessel, leading to a severe narrowing of the arterial passages.
A diseased carotid artery places immense stress on the body, potentially leading to a variety of severe health problems. The turbulent blood flow created by a buildup of plaque can eventually result in a rupture, which involves the plaque cracking and breaking apart. Ruptures can create irregular surfaces on the walls of the carotid arteries, potentially leading to the creation of a semi-solid fibrous mass known as a blood clot.
When blood clots develop in the carotid arteries, this can block blood flow to the brain and result in a stroke. Another result of a blood clot in the carotid arteries can be a transient ischemic attack (TIA), a medical condition more commonly known as a mini-stroke.
The carotid arteries are a pair of major blood vessels that carry blood to the brain, with one carotid artery on each side of the neck. The carotid arteries supply blood to the brain, making them essential for brain function. The front part of the brain, where thinking, speech, personality, and sensory and motor functions are located, receives oxygenated blood from the carotid arteries.
Each carotid artery contains a small dilation called a carotid sinus, a highly sensitive neurovascular structure which helps the body maintain an adequate blood pressure. When the carotid sinus detects unusually high blood pressure, it can send signals to the brain, prompting it to adjust the heart rate and the diameter of blood vessels in order to bring about a lower blood pressure.
Usually, carotid artery disease occurs due to atherosclerosis. Atherosclerosis occurs when there is a buildup of plaque in the arteries. Plaque, which is largely made up of cholesterol and fat, can stick to the artery walls, narrowing blood vessels throughout the body. Atherosclerosis is often brought about by lifestyle factors, including eating a diet that is high in fat and cholesterol. High blood sugar has also been found to induce atherosclerosis within the carotid arteries.
Rarely, developing carotid artery disease can also occur due to a variety of conditions other than atherosclerosis. These include:
Aneurysms: Aneurysms involve a bulge or swelling in the wall of an artery.
Carotid body tumors: A type of tumor whose growth can lead to a narrowed carotid artery.
Fibromuscular dysplasia: A vascular disorder in which abnormal clumps of cells grow within the arteries of the body, including the carotid arteries, inhibiting blood flow.
In its early stages, carotid artery disease symptoms may not be apparent. A blockage within the carotid artery may cause no noticeable symptoms until it is severe enough that a stroke occurs due a lack of oxygenated blood to the brain.
Carotid artery disease can also result in a condition called transient ischemic attack (TIA), more commonly known as a mini-stroke. A transient ischemic attack has many of the same symptoms as a stroke, though it typically lasts for a shorter period of time. To learn more about the Stroke Program at Hoag, click here.
Confirmation of carotid artery stenosis, diagnosed by a healthcare professional, is the surest path to proper treatment.
Diagnosis typically begins with a review of the patient’s medical history and a physical exam. This physical exam in which a doctor listens with a stethoscope to the carotid arteries within a patient’s neck.
Specifically, the physician is listening for a swooshing sound known as a bruit, which can be indicative of narrowed blood vessels. Should a bruit or any other symptoms of carotid artery disease be found, a physician may ask you to submit to further tests to confirm or rule out a diagnosis of carotid artery narrowing or blockage.
Tests utilizing advanced imaging technology may be necessary in order to properly diagnose carotid artery disease. Some of these tests may include:
Carotid ultrasound: During a carotid ultrasound, high-frequency sound waves are used to map out the insides of a patient’s carotid arteries. Ultrasound imaging is a minimally invasive procedure which can be used to check for narrowing of the arteries or any other potential symptoms of carotid artery disease
Computed Tomography Angiography (CTA) or Magnetic Resonance Angiography (MRA): CTA and MRA are advanced imaging tests which utilize high-contrast dye to create detailed images of the patient’s cardiovascular system. After the dye has been injected to highlight the narrowing or blockage, imaging tests are conducted which can reveal the presence of any issues within the carotid arteries
Patients may be concerned when considering the potential consequences of a carotid artery disease diagnosis. However, carotid artery stenosis, treated properly by a physician, does not always lead to stroke-causing clots.
While moderate blockages may be treated with medication and lifestyle changes, surgery may be necessary in circumstances requiring more aggressive treatment.
A variety of treatment options may be recommended by your healthcare provider, including:
Lifestyle changes: Treatment for carotid artery disease often includes making lifestyle changes that can lower cholesterol and the overall pressure being placed on the cardiovascular system. Often, lifestyle changes include quitting smoking, eating a heart-healthy diet and getting regular exercise
Carotid endarterectomy (CEA): Carotid endarterectomy, or CEA, is a type of surgery in which plaque and clots are removed from the affected carotid artery
Carotid artery stenting: This is a procedure in which a stent, a hollow mesh tube, is placed inside of a blocked carotid artery in order to hold the artery open
Transcarotid artery revascularization (TCAR): A less invasive alternative to carotid endarterectomy, the TCAR procedure involves the implantation of a stent, with blood flow within the carotid artery temporarily reversed during the procedure to keep debris such as blood clots from entering the brain
Medication: Various prescribed medications may be required in the treatment for carotid artery disease
Medications used in treatment of carotid artery stenosis include:
Blood-thinning medications: these medications help the blood supply flow more easily through a patient’s cardiovascular system, reducing the likelihood of potentially dangerous clots in the blood
Antiplatelet medications: these medications prevent blood cells from clumping together and forming a clot
Statins: a group of cholesterol-lowering medicines that come with the added benefit of increasing the diameter of the carotid artery
There are a variety of risk factors of carotid artery stenosis. Factors that can potentially put you at increased risk of developing carotid artery stenosis include:
Having high blood pressure: High pressure blood flow can damage the walls of blood vessels and increase the chances of carotid artery stenosis
Having high cholesterol: High cholesterol contributes to the buildup of plaque in the blood, which can in turn lead to a narrowed artery
Having diabetes: Diabetes increases the risk for a number of serious health conditions, including high blood pressure and cholesterol accumulating on artery walls
Smoking: Smoking tobacco can contribute or lead to a number of serious, potentially life threatening conditions, including damaging the walls of arteries and increasing blood pressure
Being older: As one ages, the arteries become brittle to such an extent that ordinary blood flow can damage them, leaving them susceptible to blood clots
Obesity: Being overweight or obese greatly increases the risk of high blood pressure and diabetes, both of which lead to increased risk of developing atherosclerosis
Having a family history of coronary artery disease, high cholesterol, heart disease, or stroke: Genetics often has a role to play in serious cardiac conditions, so the chances of developing carotid artery stenosis increase if a relative has experienced atherosclerosis, heart attack, heart failure or other forms of cardiovascular disease
There is no definitive way to prevent yourself from developing carotid artery disease. However, there are a number of steps you can take that might lower your risk of the condition.
Because carotid artery disease is typically caused by atherosclerosis, patients usually have to make many of the same lifestyle changes undertaken to lower the risk of heart disease.
Steps you can take to lower your risk of developing carotid artery disease may include:
Diet changes: In those with carotid artery narrowing or blockages, consumption of sugar, salt, saturated fats and alcohol should be limited. A healthy diet that includes plenty of fruits, vegetables and lean meats is usually recommended.
Quit smoking: Smoking can lead to or contribute to a range of serious cardiovascular conditions and complications, including atherosclerosis, heart disease, high blood pressure and carotid artery disease.
Maintaining a healthy weight: Obesity can result in greatly increased risk for carotid artery stenosis, as well as increase the risk of developing other conditions like diabetes and high blood pressure.
Visit our vascular treatment page or vascular disease diagnosis and testing page to learn more.
Atherosclerosis-related diseases like renal artery disease, coronary artery disease and carotid artery disease are quiet killers, slowly narrowing the arteries over years due to plaque buildup. By the time you know you have a problem, it can be a true emergency.
Vascular disease is nothing to take lightly. So don’t wait. Connect with our subspecialized team today through our online form or by calling 949-764-5871.