Carotid artery stenosis

Carotid artery stenosis is a condition characterized by the narrowing of the carotid arteries, which are major blood vessels that supply oxygenated blood to the front part of the brain. This narrowing is typically caused by the buildup of plaque, a mixture of fat, cholesterol, and other substances. Carotid artery stenosis can lead to significant health problems, including stroke, due to reduced blood flow to the brain or by causing a clot to form that blocks a smaller artery in the brain.

Causes and Risk Factors

The primary cause of carotid artery stenosis is atherosclerosis, a process in which plaque builds up on the inner walls of arteries. Risk factors for atherosclerosis and, consequently, carotid artery stenosis include:

• High blood pressure
• High cholesterol
• Diabetes
• Smoking
• Obesity
• Family history of atherosclerosis or carotid artery disease
• Age, particularly individuals over 60 years old

Symptoms

In many cases, carotid artery stenosis does not cause noticeable symptoms until it is severe enough to disrupt blood flow. However, warning signs may include:

• Transient ischemic attack (TIA) or "mini-stroke"
• Sudden weakness or numbness in the face, arms, or legs, especially on one side of the body
• Difficulty speaking or understanding speech
• Sudden vision problems in one or both eyes
• Dizziness or loss of balance

Diagnosis

Diagnosis of carotid artery stenosis involves a combination of medical history, physical examination, and diagnostic tests, including:

• Doppler ultrasound, which uses sound waves to visualize the blood flow and detect narrowing of the arteries
• Angiography, where a special dye is injected into the bloodstream to make the arteries visible on X-ray
• Magnetic resonance angiography (MRA) or Computed Tomography Angiography (CTA), which provide detailed images of the arteries

Treatment

Treatment for carotid artery stenosis aims to reduce the risk of stroke and may include:

• Lifestyle changes, such as eating a healthy diet, exercising, quitting smoking, and controlling blood pressure and cholesterol
• Medications to prevent blood clots, lower blood pressure, and reduce cholesterol levels
• Surgical procedures, such as carotid endarterectomy (CEA), where the plaque is surgically removed from the artery, or carotid artery angioplasty and stenting, where the artery is widened and a stent is placed to keep it open

Prevention

Preventing carotid artery stenosis largely involves managing its risk factors. This includes adopting a healthy lifestyle, such as eating a balanced diet, engaging in regular physical activity, avoiding tobacco use, and maintaining a healthy weight. Regular medical check-ups are also important to monitor and manage conditions that increase the risk of atherosclerosis and carotid artery stenosis.