Carotid Artery Disease

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What is carotid artery disease?

The carotid arteries run along both sides of the neck and supply oxygen-rich blood to the brain, face, scalp and neck. Like the smaller coronary arteries of the heart, the carotid arteries over time can become clogged with a waxy substance called plaque. Over time plaque becomes calcified and plaque fragments can follow the circulation upstream towards the brain. Carotid plaque buildup not only reduces the amount of blood that can flow through the neck blood vessels (stenosis) but also causes carotid artery stiffening (sclerosis). This is carotid artery disease, accurately described as “hardening of the arteries”.

Carotid artery disease is a major risk factor for vascular dementia and stroke, which it can cause in two ways. First, a carotid artery blockage can stop the flow of freshly oxygenated blood to the brain, which may cause brain tissue to die. Second, small calcified fragments of plaque in the artery can break off and travel to the brain, blocking small blood vessels and depriving the nearby tissue of oxygen.

Carotid artery disease often does not produce any symptoms until a stroke or mini-stroke occurs. However, your doctor may be able to detect carotid artery disease during a routine physical exam. If you have carotid artery disease, your doctor may treat it by prescribing medication or performing a procedure to remove plaque or place a stent to hold the artery open. Carotid artery disease treatment is tailored to the individual patient and is based on stroke history, age, and general health status.

What are the symptoms of carotid artery disease?

Carotid stenosis may not produce any symptoms until the condition causes a stroke or a transient ischemic attack (TIA or “mini-stroke”). During an office visit, your doctor may be able to detect a bruit, a specific sound of blood flow through your carotid arteries.

Common symptoms of TIA or stroke

TIA and stroke symptoms include:

  • Sudden onset of severe headache

  • One-sided weakness or facial drooping

  • Difficulty saying a complete sentence

  • Inability to move your arms or legs on one side

  • Feeling dizzy or losing your balance

If you or someone with you is experiencing signs of stroke, seek emergency medical attention—dial 911!

What causes carotid stenosis and disease?

Carotid artery disease begins when the lining of the arteries becomes damaged and plaques develop to help heal the injury. The damage occurs over many years. Carotid artery damage can be caused by:

  • High blood pressure

  • High cholesterol

  • Diabetes

  • Smoking

What are the risk factors for carotid artery disease?

The risk factors for carotid artery disease include items you can control and others you cannot. The major risk factors for carotid stenosis are:

Reducing your risk of carotid artery disease

You may be able to lower your risk of developing carotid artery stenosis by following a heart-healthy lifestyle that includes:

  • Eating a diet that is high in fiber and fruits and vegetables

  • Maintaining a healthy weight

  • Participating in a regular exercise program

  • Quitting smoking

  • Treating diabetes, hypertension, high cholesterol, and other medical conditions that put you at risk for cardiovascular disease

How is carotid artery disease treated?

Your carotid artery disease treatment plan will depend on whether or not you have symptoms or have had a stroke. Treatment for carotid artery disease may include:

  • Lifestyle changes, such as quitting smoking, exercising, and eating a high-fiber diet

  • Medications to prevent blood clots, lower cholesterol, treat high blood pressure, or reduce blood sugar

  • Carotid endarterectomy, a surgical procedure to remove the diseased inner lining from one or both carotid arteries

  • Carotid angioplasty, a minimally invasive procedure that uses a small balloon to compress plaque against the artery wall and widen the opening to allow better blood flow

  • Carotid artery stenting, a minimally invasive procedure that places a mesh coil inside the artery to hold it open. A vascular surgeon may perform angioplasty and stenting at the same time.

What are the potential complications of carotid artery disease?

Stroke is the major potential complication of carotid artery disease. You can help minimize your risk of complications from carotid artery disease by following the treatment plan you and your health professional design specifically for you. Potential complications of stroke are:

  • Cognitive deficits (vascular dementia), such as memory loss and inability to reason

  • Complete or partial paralysis of arms, legs and face

  • Persistent one-sided body weakness

  • Trouble swallowing and speaking

  • Vision problems in one or both eyes

  • Premature death

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Jan 25
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

  1. Carotid Artery Disease. MedlinePlus, U.S., National Library of Medicine. https://medlineplus.gov/carotidarterydisease.html

  2. What Is Carotid Artery Disease? National Heart, Lung and Blood Institute. https://www.nhlbi.nih.gov/health/health-topics/topics/catd

  3. Carotid Artery Disease. SecondsCount.org. http://www.secondscount.org/heart-condition-centers/carotid-artery-disease#.Wbgh_9GQxPZ

  4. Wendell CR, Waldstein SR, Ferrucci L et al. Carotid Atherosclerosis and Prospective Risk of Dementia. Stroke. 2012;43:3319-3324.