What is Carotid Stenosis?

Carotid stenosis (also called “carotid artery disease” or CAD) happens when fatty deposits and cholesterol build up in your carotid arteries, causing them to narrow.

Your carotid arteries are located on the sides of your neck and are your brain’s main pipelines for blood, oxygen and nutrients. When they narrow, it lessens your brain’s supply.

What Causes Carotid Stenosis?

Carotid stenosis is the result of deposits in your carotid arteries, called “plaques,” made of fat and cholesterol.

The plaques can come in a few forms:

• Smooth and fibrous plaques, which are not likely to cause a rupture
• Fragile and inflamed plaques, which are more likely to rupture

Fragile, inflamed plaques often occur when the body sees the deposit as an injury, and tries to repair it by building a clot around it. When this happens, it narrows the artery further and creates a clot that may break free and become lodged in another section of blood vessel, causing a stroke.

Symptoms and Detection for Carotid Stenosis

You likely won’t notice any symptoms of carotid stenosis. The condition is usually diagnosed during a clinical exam using a stethoscope, or after you have a stroke or transient ischemic attack (TIA) when a piece of clotting breaks free.

Tests commonly used to screen for and diagnose carotid stenosis include:

• Ultrasound, a painless, non-invasive initial screening of your carotid arteries
• Carotid angiogram, to confirm the carotid artery diagnosis, if your ultrasound shows signs of the disease

Treatment for Carotid Stenosis

Minor carotid stenosis blockage can often be treated with medical therapy.

If your blockage is more than 70 percent, and you’re experiencing symptoms, you’ll likely need surgery to prevent blood clots and stroke. These include:

• Carotid endarterectomy, the most common treatment, where the surgeon makes an incision into the artery to clear out the blockage
• Carotid stenting, a minimally-invasive procedure that places a metal stent in your artery to move aside the blockage and open the artery

Risk Factors for Carotid Stenosis

Several factors affect your risk of developing carotid stenosis, including:

• High blood pressure and high blood fat, which encourage plaque buildup and create excess pressure on your artery walls
• Tobacco use, which can irritate the lining of your artery walls and raise your blood pressure
• Obesity and sedentary lifestyle, which can raise your blood pressure. They can also contribute to another risk factor: Diabetes.
• Family history
• Increased age

You can’t control all risk factors of carotid stenosis, but there are some lifestyle changes you can make, such as quitting or never using tobacco products and improving your diet and exercise regimen.