Carotid artery disease refers to narrowing of the carotid arteries, the major blood vessels in the neck that supply blood to the brain. Because these arteries are a common source of the blood clots that cause ischemic stroke, understanding carotid artery disease is an important part of overall stroke risk awareness. This article provides a plain-language overview of the condition, its symptoms, and how it is generally evaluated.
What Causes Carotid Artery Disease?
Carotid artery disease most commonly results from atherosclerosis, a gradual buildup of fatty plaque along the inner wall of the artery. Over time, this plaque can narrow the vessel (stenosis), reducing blood flow, or pieces of plaque and associated clot can break loose and travel toward the brain, potentially causing a stroke or transient ischemic attack (TIA).
Commonly cited risk factors for carotid artery disease include:
- High blood pressure
- High cholesterol
- Smoking
- Diabetes
- Older age
- Family history of vascular disease
What Are the Symptoms of Carotid Artery Disease?
Many people with carotid artery narrowing have no symptoms at all, and the condition is often first identified through a physical exam finding (such as a sound called a bruit heard over the artery) or incidentally during imaging performed for another reason.
When symptoms do occur, they are often related to a TIA or stroke caused by reduced blood flow or a clot originating from the artery, and may include:
- Sudden weakness or numbness on one side of the body
- Sudden difficulty speaking or understanding speech
- Sudden vision loss or changes in one eye
- Sudden confusion or dizziness
Any of these symptoms should be treated as a possible stroke. Call emergency services immediately rather than waiting to see if symptoms resolve, since even brief episodes can indicate a TIA that carries meaningful risk of a subsequent, larger stroke.
How Is Carotid Artery Disease Diagnosed?
Physicians typically use a combination of physical examination and imaging to evaluate suspected carotid artery disease, including:
- Carotid duplex ultrasound, a common first-line, non-invasive imaging test
- CT angiography (CTA) or MR angiography (MRA) for more detailed vessel visualization
- Catheter-based angiography in select cases requiring more precise anatomical detail
How Is Carotid Artery Disease Managed?
Management depends on the degree of narrowing, whether the patient has had symptoms, and overall cardiovascular risk. Physicians may consider:
- Medical management, including cholesterol-lowering medication, blood pressure control, antiplatelet therapy, and lifestyle modification
- Carotid endarterectomy, a surgical procedure to remove plaque from the artery
- Carotid artery stenting, a catheter-based procedure to open the narrowed segment and support the vessel wall
The most appropriate approach is determined individually by a physician based on stenosis severity, symptom history, and the patient's overall surgical risk profile.
Frequently Asked Questions
Can carotid artery disease exist without any symptoms?
Yes. Many people have some degree of carotid narrowing without ever experiencing symptoms, which is why it is sometimes discovered incidentally during a routine exam or imaging performed for another reason.
Is carotid artery disease the same as a stroke?
No. Carotid artery disease is a narrowing of the neck arteries that can increase stroke risk, while a stroke is the actual event of blocked or reduced blood flow to the brain. Carotid disease is a risk factor and potential source for certain ischemic strokes.
Who typically evaluates candidacy for carotid stenting versus surgery?
Vascular surgeons, neurointerventionalists, and interventional cardiologists typically evaluate candidacy for carotid procedures based on stenosis severity, plaque characteristics, symptom history, and overall surgical risk. This determination is made on an individual basis by the treating physician.
Related INVAMED Resources
- Neurovascular Interventions — INVAMED's neurovascular device portfolio
- What Is Ischemic Stroke? — how blocked brain arteries cause stroke
- Contact INVAMED — request information about neurovascular devices
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