What is Carotid Stenosis?

Carotid stenosis refers to plaque buildup in one or both of the carotid arteries in the neck. The carotid arteries become narrow and obstructed when cholesterol deposits stick to the arterial walls and harden into a tough plaque. Blood flow to the face and brain can be severely restricted as a result, and a person is at risk of suffering a stroke. When carotid stenosis is detected early, the problem can often be reversed by making healthy lifestyle choices. If a stroke occurs or appears imminent, however, surgery usually is necessary to avoid future complications.

Cholesterol can accumulate in the carotid arteries and other vital blood vessels for several reasons. People with family histories of heart disease and carotid stenosis are at risk because genetics is a major factor. Smoking, eating fatty foods, and not getting enough exercise can raise cholesterol to dangerous levels as well. High blood pressure, obesity, diabetes, and congenital heart or blood disorders also increase the chances of developing carotid stenosis.

The condition rarely causes symptoms in its early stages, and thus often goes undiagnosed until complications such as stroke arise. A stroke can occur because a carotid artery becomes so narrow that little or no blood can pass through. It is also possible for a piece of plaque to break away from the wall and lodge itself into a smaller blood vessel further up the neck, resulting in a complete blockage. If a stroke does occur, a person may experience tingling sensations or weakness on one side of the face and body, mental confusion, vision or speaking problems, and a painful headache. It is important to seek immediate medical care for a person if he or she shows signs of an impending stroke.

A doctor may be able to detect carotid stenosis in its early stages during a routine physical exam. Using a stethoscope, a physician can listen to the sounds made as blood passes through the carotid arteries. Any pauses or unusual noises that are discovered indicate that further tests are needed. In order to confirm carotid stenosis, the doctor may take ultrasounds of the arteries or specialized x-rays called angiographs to trace the flow of blood in the neck.

Early-stage stenosis can usually be cured with lifestyle changes and medications. Patients are advised to quit smoking, start exercising more, and watch their diets carefully. A person may also be instructed to take low-dose aspirin daily to thin the blood and reduce the chances of clotting in the narrow arteries. Some patients also are prescribed drugs to reduce cholesterol levels and promote better blood flow.

A very serious case of carotid stenosis usually requires surgery. A surgeon may choose to place a mesh stent in the artery to expand the walls and hold the vessel open. Another option involves cutting the artery open, manually removing the plaque, and stitching it back together. Lifestyle changes and regular medical checkups are important after either procedure to make sure problems do not return.