Definition

Carotid artery stenosis occurs when the carotid arteries narrow. The carotid arteries are major arteries found on each side of the neck. They supply blood from the heart to the brain.

This condition is a major risk factor for ischemic stroke. Ischemic stroke is when blood flow to the brain is blocked due to blood clots.

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Causes

Carotid artery stenosis is caused by the build-up of plaque along the lining of the arteries. This build-up is known as atherosclerosis. Plaque is made up of cholesterol, fat, and other substances.

Risk Factors

Carotid artery stenosis is more common in men aged 75 or younger and women aged 75 or older. Risk factors include:

• Family history of atherosclerosis
• Coronary artery disease (CAD)
• Peripheral artery disease (PAD)—disease of the arteries (usually in the legs) caused by fatty build-up
• Smoking
• High blood pressure
• Diabetes
• High cholesterol
• Obesity

Symptoms

There are usually no symptoms. Tell your doctor if you have symptoms of a stroke or a transient ischemic attack (TIA or mini-stroke). This is a warning sign that you may have carotid artery stenosis. Symptoms may include:

• Blindness, blurry or dim vision
• Weakness, numbness, or tingling of the face, arm, leg, or one side of the body
• Difficulty speaking or understanding words
• Lightheadedness, unsteadiness of gait, or falling
• Trouble with balance or coordination
• Loss of consciousness
• Nausea or vomiting
• Sudden confusion or loss of memory

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.

Imaging tests may include:

• Carotid ultrasonography
• Computer tomography angiography (CTA)
• Magnetic resonance angiography (MRA)

Treatment

The goal of treatment is to prevent carotid artery stenosis from causing inadequate blood flow to the brain or causing a stroke. Treatment will depend on:

• The severity of your condition
• Your symptoms

Talk with your doctor about the best treatment plan for you. Treatment options include:

Prevention

To help reduce your chance of getting carotid artery stenosis, you will need to decrease the risk factors that you can control. For example, you can reduce your cholesterol, blood pressure, and weight. Here are some steps to decrease these risk factors:

• Exercise regularly.
• Eat more fruits and vegetables. Limit dietary salt and fat.
• If you smoke, talk to your doctor about ways to quit.
• If you drink alcohol, do so only in moderation. This means having no more than 2 drinks per day if you are a man, and no more than 1 drink per day if you are woman.
• Maintain a healthy weight.
• Keep your blood pressure in a safe range. Follow your doctor's recommendations if you have high blood pressure.
• Keep other conditions under control. This includes high cholesterol and diabetes.