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Carotid artery disease occurs when the carotid arteries become narrowed or blocked.
The carotid arteries provide the main blood supply to your brain. They are located on each side of your neck. You can feel their pulse under your jawline.
Carotid stenosis; Stenosis - carotid
Carotid artery disease occurs when fatty material called plaque builds up inside the arteries. This buildup of plaque is called atherosclerosis (hardening of the arteries).
The plaque may slowly block or narrow the carotid artery. Or it may cause a clot to form suddenly. A clot that completely blocks the artery can lead to stroke.
Risk factors for blockage or narrowing of the arteries include:
Smoking (people who smoke one pack a day double their risk of stroke)
At early stages, you not may any symptoms. After plaque builds up, the first symptoms of carotid artery disease may be a stroke or a transient ischemic attack (TIA). A TIA is a small stroke that doesn't cause any lasting damage.
Symptoms of stroke and TIA include:
Your health care provider will perform a physical exam. Your provider may use a stethoscope to listen to the blood flow in your neck for an unusual sound called a bruit. This sound may be a sign of carotid artery disease.
Your provider also may find clots in the blood vessels of your eye. If you have had a stroke or TIA, a nervous system (neurological) exam will show other problems.
You may also have the following tests:
The following imaging tests may be used to examine the blood vessels in the neck and brain:
Treatment options include:
You may have certain procedures to treat a narrowed or blocked carotid artery:
Major complications of carotid artery disease are:
Transient ischemic attack. This occurs when a blot clot briefly blocks a blood vessel to the brain. It causes the same symptoms as stroke. Symptoms last only a few minutes to an hour or two, but no longer than 24 hours. A TIA does not cause lasting damage. TIAs are a warning sign that a stroke may happen in the future if nothing is done to prevent it.
Stroke. When the blood supply to the brain is partly or completely blocked, it causes a stroke. Most often, this happens when a blood clot blocks a blood vessel to the brain. A stroke can also occur when a blood vessel breaks open or leaks. Stokes can cause long-term brain damage or death.
Go to the emergency room or call the local emergency number (such as 911) as soon as symptoms occur. The sooner you receive treatment, the better your chance for recovery. With a stroke, every second of delay can cause more brain injury.
Here's what you can do to help prevent carotid artery disease and stroke:
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.
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