kathi

Carotid Artery Disease


Overview:

Quick Reference

Reviewed by Dr. Rich Alweis

Carotid artery disease in the neck and brain is like coronary artery
disease in the heart. It occurs when plaque builds up in the carotid
arteries, which supply oxygen-rich blood to the brain.

If the arteries get blocked and the brain does not get enough oxygen, a
stroke may occur. A stroke, or “brain attack,” is like a heart attack in
the brain, and can cause death or permanent disability. It is the third
largest killer in the United States.

Detailed Information

Blood is delivered from the heart to the brain through four arteries:
two carotid arteries in the front of your neck, and two smaller
vertebral arteries in the back. You can feel the carotid arteries by
pressing gently on either side of your windpipe. When you feel your
pulse, those are the carotid arteries.

Atherosclerosis occurs when fat and cholesterol deposits
(“plaque”) build up in your arteries. Plaque slows the flow of blood to
the brain (or, in the case of coronary artery disease, the heart). There
are three ways this can lead to a stroke:

the plaque can severely narrow the arteries a blood clot can become
wedged in the artery plaque from the carotid arteries can break off and
block a smaller artery

If the brain is denied oxygen for more than three hours, the damage can
be permanent.

Risk Factors

If you have carotid artery disease, you probably have coronary artery
disease as well. Both have similar risk factors:

high blood pressure diabetes mellitus high levels of “bad cholesterol”
smoking family history of coronary or carotid artery disease obesity
lack of exercise (sedentary lifestyle)

Symptoms

Carotid artery disease often has no symptoms. But a transient ischemic
attack (TIA, sometimes called a “mini-stroke”) is a warning that you
might soon have a stroke. These are temporary episodes of stroke-like
symptoms, which may last a few minutes or a few hours. Symptoms of TIA
(or stroke) include:

headache dizziness tingling confusion numbness facial droop paralysis

Other symptoms of carotid artery disease include:

weakness, paralysis, numbness or tingling on one side of your arm, leg
or face on one side of your body loss of eyesight or blurry eyesight
sudden, severe, unexplainable headache

Diagnosis

There are a variety of tools for diagnosing carotid artery disease. Your
doctor may be able to diagnose it using a stethoscope during a normal
checkup. But this method can produce false negatives, meaning you may
have the disease even if your doctor does not detect it. It can also
make your blockage seem more severe than it really is.

There are other diagnostic tools:

Doppler ultrasound imaging uses sound waves to check blood flow and
measure artery thickness. Magnetic Resonance Angiography uses magnetic
fields to generate a picture of your arteries. Oculoplethysmography
measures the arteries’ pulsation Various methods can be used to x-ray
the carotid arteries.

Treatment/Prevention

If you have a stroke, go to the emergency room immediately. With modern
treatments, many people who are treated early for their stroke can have
an almost complete recovery.

Treatment options for carotid artery disease include lifestyle changes,
medication and surgery. You should also find out if you have heart
rhythm or circulation problems that could increase your risk, and treat
those problems. Quitting smoking, lowering the amount of cholesterol and
salt in your diet, exercising and losing weight can help. Limit your
alcohol intake to one to two drinks a day for men and one drink a day
for women. You can also take blood thinning medications or aspirin. If
you have to take these medications, you will probably take them for the
rest of your life. There are also procedures and surgery to open your
arteries. For carotid angioplasty, a balloon catheter is used to flatten
plaque blockages, and a small metal device called a stent is placed in
the artery to keep it open. Carotid endarterectomy actually removes the
plaque. The surgeon makes an incision in the neck, at the location of
the blockage. A tube is temporarily inserted to reroute blood flow while
the surgeon removes the plaque.

http://www.medtech1.com/research_center/cond20.cfm/204