Causes

Carotid artery disease is caused by plaque (a sticky substance made up of cholesterol, calcium and fibrous tissue) in the carotid artery. A buildup of plaque causes the artery to narrow and harden, resulting in reduced blood flow to the brain.

There are things you can do to reduce your risk of developing carotid artery disease:

• Control your blood pressure
• Control your blood sugar levels
• Eat a healthy diet, low in saturated fat
• Exercise regularly
• Maintain a healthy cholesterol level
• Maintain a healthy weight
• Quit smoking

Symptoms

Often, there are no symptoms associated with the beginning stages of carotid artery disease, and unfortunately, stroke can sometimes be the first sign. Warning signs of a stroke (known as transient ischemic attacks or TIAs) can include:

• Weakness, tingling or numbness on one side of the body
• Inability to control movement of one or more limbs
• Loss of vision in one eye
• Slurred speech or loss of ability to speak

Even if these symptoms resolve quickly, they indicate a strong possibility of an impending stroke. If you experience any of these symptoms, contact your physician immediately.

Why choose Ohio State for carotid artery disease treatment?

Physicians at Ohio State's Wexner Medical Center have expertise in treating carotid artery disease. We educate our patients about lifestyle habits and medications that may keep the disease from progressing. Ohio State is home to skilled physicians who perform surgery as well as minimally invasive procedures to treat all stages of carotid artery disease.

Diagnosis

Your physician uses a stethoscope to listen to your carotid arteries. He or she will listen for a bruit (whooshing sound) that indicates reduced blood flow. During this visit, your physician will also inquire about symptoms you have experienced and identify if you have any conditions that increase your risk of developing carotid artery disease. 

After performing a physical exam and learning about your symptoms and medical history, your doctor may choose to test for carotid artery disease. Tests include:

• Carotid duplex – This painless procedure is performed by placing a small ultrasound wand on your neck that emits high-frequency sound waves. The sound waves bounce off of blood cells and blood vessels to identify any problems with the structure of your blood vessels or blood flow.
• CT angiogram (computed tomography angiogram) – An imaging procedure that uses CT technology to produce cross-sectional, detailed images of blood vessels.
• MRA (magnetic resonance angiography) – A noninvasive imaging procedure that uses large magnets, radiofrequencies and a computer to evaluate blood flow through arteries.
• Carotid angiography – A procedure to check for problems in carotid arteries. A long, thin tube (catheter) is inserted into the carotid artery. The physician injects a contrast solution into the artery and takes X-rays to check for blockages and other abnormalities.

Treatments

Nonsurgical

Your physician may recommend lifestyle changes such as quitting smoking, beginning an exercise regimen and lowering saturated fat in your diet to stop carotid artery disease from progressing. He or she may also recommend medications such as aspirin to thin your blood or statins to control blood lipid (fat) levels.

Surgical

If you are experiencing warning signs of a stroke, have experienced a stroke or have severe narrowing of the arteries with or without symptoms, surgery may be necessary. Surgical procedures include:

• Carotid endarterectomy – The surgeon makes an incision in your neck to remove the plaque from the inner lining of your carotid artery. This is a safe procedure that requires general anesthetic and yields long-lasting effects.
• Angioplasty stenting – This is a newer, minimally invasive procedure using local anesthesia that is suitable for some patients with carotid disease. A catheter (thin, long tube) is inserted through your groin artery and guided through the blood vessels to your carotid artery. A contrast dye is injected through the catheter and an X-ray is taken to reveal exactly where the obstruction is occurring within the artery. The surgeon then inserts a second catheter carrying a tiny balloon that inflates and deflates to open up the artery by flattening the plaque against the artery walls. Finally, the physician places a stent in the artery to hold it open and allow for proper blood flow.