St. Luke's Hospital
Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
Find a Physician Payment Options Locations & Directions
Follow us on: facebook twitter Mobile Email Page Email Page Print Page Print Page Increase Font Size Decrease Font Size Font Size
America's 50 Best Hospitals
Meet the Doctor
Spirit of Women
Community Health Needs Assessment
Home > Health Information

Multimedia Encyclopedia

    Print-Friendly
    Bookmarks

    Carotid artery disease

    Carotid stenosis; Stenosis - carotid

    Carotid artery disease is a condition in which the carotid arteries become narrowed or blocked. When the arteries become narrowed, the condition is called carotid stenosis.

    The carotid arteries provide the main blood supply to the brain. They are located on each side of your neck. You can feel their pulse under the jawline.

    Causes

    Carotid artery disease occurs when sticky, fatty substances called plaque build up in the inner lining of the arteries. See also: Atherosclerosis (hardening of the arteries)

    The plaque may slowly block or narrow the carotid artery or cause a clot (thrombus) to form more suddenly. Clots can lead to stroke.

    Risk factors for blockage or narrowing of the arteries include:

    • Alcohol abuse
    • Cocaine use
    • Diabetes
    • Family history of stroke
    • High blood pressure
    • High cholesterol
    • Increasing age
    • Smoking (people who smoke one pack a day double their risk of a stroke)

    Two uncommon conditions called Marfan syndrome and fibromuscular dysplasia (abnormal growth or development of the cells in the walls of carotid arteries) may also cause narrowing of the carotid arteries.

    Symptoms

    You may not have any symptoms of carotid artery disease.

    You may have symptoms of a stroke or a transient ischemic attack (TIA). Some of these symptoms include:

    • Blurred vision
    • Confusion
    • Loss of memory
    • Loss of sensation
    • Problems with speech and language
    • Vision loss
    • Weakness in one part of your body

    Exams and Tests

    Your health care provider will perform a physical exam. The health care provider may hear an abnormal sound called a bruit when using a stethoscope to listen to the blood flow in your neck.

    A physical exam may also reveal clots in the blood vessels of the eye. If you have had a stroke or TIA, a nervous system (neurological) exam will reveal other problems.

    The following tests may be done:

    • Blood cholesterol and triglycerides test
    • Blood sugar (glucose) test
    • Ultrasound of the carotid arteries (carotid duplex Doppler study) to see how well blood is flowing through the carotid artery

    The following imaging tests may be used to examine the blood vessels in the neck and brain:

    • Carotid or cerebral angiography
    • Computerized tomographic angiography (CTA)
    • Magnetic resonance angiography (MRA)

    Treatment

    Treatment options include:

    • Blood-thinning medicines such as aspirin, clopidogrel (Plavix), and warfarin (Coumadin) to lower your risk of stroke
    • Medicine and diet to lower your cholesterol
    • Medicine and diet to control your blood pressure
    • No treatment, other than checking your carotid artery with tests every year

    There are two invasive ways to treat a carotid artery that is narrowed or blocked. These procedures are done to prevent new strokes in people with large blockages.

    • Surgery, called carotid endarterectomy, is done to remove the buildup in your carotid arteries. See: Carotid artery surgery
    • Carotid angioplasty and stenting (CAS) is done through a much smaller surgical cut, by pushing instruments into your arteries and placing a wire mesh inside the artery through a tube in the groin.

    Outlook (Prognosis)

    Stroke is a leading cause of death in the United States. Some people who have a stroke recover most or all of their functions. Others die from the stroke itself or from complications. About half of those who have a stroke have long-term problems.

    Possible Complications

    The major complications with carotid artery disease are:

    • Transient ischemic attack (TIA). This is an episode in which a person has stroke-like symptoms for less than 24 hours, usually less than 1-2 hours. A TIA is often considered a warning sign that a stroke may happen in the future if something is not done to prevent it.
    • Stroke. A stroke can happen when a blood vessel in any part of the brain is blocked. The blood flow through the narrowed carotid artery may slow so much that a clot forms. A stroke may also occur if a small piece of a blood clot breaks off and travels to a smaller artery in the brain.

    When to Contact a Medical Professional

    Go to the emergency room or call the local emergency number (such as 911) as soon as symptoms occur. When having a stroke, every second of delay can result in more brain injury.

    Prevention

    The following can help prevent a stroke:

    • Adults should have their cholesterol checked every 5 years and treated, if needed. If you have been treated for high cholesterol, you will need to have it checked more often.
    • Avoid fatty foods. Follow a healthy, low-fat diet.
    • Do not drink more than 1 -2 alcoholic drinks a day.
    • Exercise regularly: 30 minutes a day if you are not overweight; 60 - 90 minutes a day if you are overweight.
    • Get your blood pressure checked every 1 - 2 years, especially if high blood pressure runs in your family. If you have high blood pressure, heart disease, diabetes, or you have had a stroke, you need to have it checked more often. Ask your doctor.
    • Quit smoking.

    Follow your doctor's treatment recommendations if you have high blood pressure, diabetes, high cholesterol, or heart disease.

    References

    Brott TG, Halperin JL, Abbara S, et al. American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, et al. 2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS guideline on the management of patients with extracranial carotid and vertebral artery disease: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American Stroke Association, American Association of Neuroscience Nurses, American Association of Neurological Surgeons, American College of Radiology, American Society of Neuroradiology, Congress of Neurological Surgeons, Society of Atherosclerosis Imaging and Prevention, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of NeuroInterventional Surgery, Society for Vascular Medicine, and Society for Vascular Surgery. Vasc Med. 2011;16:35-77.

    Brott TG, Hobson RW 2nd, Howard G, Roubin GS, Clark WM, Brooks W, et al. Stenting verses endarterectomy for treatment of carotid-artery stenosis. N Engl J Med. 2010;363:11-23.

    BACK TO TOP

          A Closer Look

          Talking to your MD

            Self Care

              Tests for Carotid artery disease

              Review Date: 7/31/2011

              Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

              The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
              adam.com

              A.D.A.M. content is best viewed in IE9 or above, Fire Fox and chrome browser.


              Back  |  Top
              About Us
              Contact Us
              History
              Mission
              Locations & Directions
              Quality Reports
              Annual Reports
              Honors & Awards
              Community Health Needs
              Assessment

              Newsroom
              Services
              Brain & Spine
              Cancer
              Heart
              Maternity
              Orthopedics
              Pulmonary
              Sleep Medicine
              Urgent Care
              Women's Services
              All Services
              Patients & Visitors
              Locations & Directions
              Find a Physician
              Tour St. Luke's
              Patient & Visitor Information
              Contact Us
              Payment Options
              Financial Assistance
              Send a Card
              Mammogram Appointments
              Health Tools
              My Personal Health
              mystlukes
              Spirit of Women
              Health Information & Tools
              Clinical Trials
              Health Risk Assessments
              Employer Programs -
              Passport to Wellness

              Classes & Events
              Classes & Events
              Spirit of Women
              Donate & Volunteer
              Giving Opportunities
              Volunteer
              Physicians & Employees
              For Physicians
              Remote Access
              Medical Residency Information
              Pharmacy Residency Information
              Physician CPOE Training
              Careers
              Careers
              St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
              Copyright © St. Luke's Hospital Website Terms and Conditions  |  Privacy Policy  |  Patient Notice of Privacy Policies PDF Sitemap St. Luke's Mobile