- What are carotid arteries and why do they matter?
- What are the symptoms of carotid stenosis?
- Can you prevent carotid stenosis?
Every 40 seconds in the U.S., someone experiences a stroke, a potentially life-threatening medical event. About 87% of these are ischemic strokes, where blood flow is cut off from the brain, often caused by a condition known as carotid stenosis. Adam B. Levitt, M.D., R.V.T., F.A.C.S., board-certified vascular surgeon at Vascular Specialists of Central Florida, Inc. says, “One of the common conditions that are referred to us is carotid stenosis, which is a narrowing of the arteries.”
When your arteries narrow, your risk of stroke increases. To help you understand why this occurs and how you can prevent it, we’ll go over the process that takes place in your arteries, their importance to your health, as well as the condition known as carotid stenosis.
What Are Your Carotid Arteries and Why Do They Matter?
Dr. Levitt says, “A carotid artery is one of the four blood vessels that go to the brain. You have a carotid artery on either side of your neck and you have two vertebral arteries at the back of the neck.” These arteries pump hormones, nutrients, and oxygen to the brain. Without this blood flow for even a few seconds, your brain starts to die. It’s your arteries that help keep you alive. When you’re healthy, the pipe is flowing smoothly with nothing in the way. When the pipe is blocked, major problems can occur.
To understand the carotid artery, you must first understand the circulatory system. An artery is an important part of the body’s cardiovascular system, tasked with moving oxygen-rich blood from the heart throughout the body to feed and nourish your organs. The tissues that make up your body need this constant nourishment to function.
The carotid arteries are two of the four critical tubes that provide these nutrients to your brain. The brain, of course, is the hub that controls your ability to function, everything from the automatic beating of your heart and breathing to movement and memory. When the brain loses oxygen, the entire body can shut down.
Sometimes, the arteries can become blocked with a blood clot or fatty sludge known as cholesterol or plaque. High cholesterol or high plaque build-up is known as atherosclerosis.
Obstructions like these cut off the blood supply to the brain, causing a stroke. Dr. Levitt says, “If there’s a narrowing of the carotid artery it puts you at higher risk of having a stroke. As that narrowing increases, your risk of stroke goes up.”
What Are the Symptoms of Carotid Stenosis?
Dr. Levitt says, “People with carotid disease are either asymptomatic or symptomatic.” Symptomatic patients show visible signs of carotid stenosis. These could include:
- Blurred or lost vision in one eye
- Drooping on one side of the face
- Loss of feeling on one side of the body
- Suddenly losing arm or leg strength
- The loss of speech, trouble forming words, slurred speech
However, carotid stenosis can also be asymptomatic, occurring slowly inside your body without showing symptoms. Dr. Levitt says, “Asymptomatic means no symptoms, but you still have the blockage. For these individuals, we usually will not intervene surgically, until you have a greater than 80% stenosis.”
Instead, Dr. Levitt says, “You will be treated medically, usually with baby aspirin and statin medication to control your cholesterol.” Throughout treatment, Dr. Levitt and his team will continue to monitor the narrowing artery with ultrasounds. Dr. Levitt says, “How narrow your artery is will determine how often we take ultrasounds—Usually between every six months and a year.”
Dr. Levitt says the stroke-like symptoms of carotid stenosis “can be permanent or pass by in less than 30-seconds.” Even for patients with symptoms that pass quickly, “if they have a greater than 50% blockage, they most likely will need some kind of (surgical) intervention.”
If necessary, doctors can perform procedures to remove the plaque. However, not every case of carotid stenosis requires surgery. Many times, you can manage the condition with lifestyle changes. The first step is to meet with a doctor who can check to see how severely the artery is blocked.
How Is Carotid Stenosis Diagnosed?
Carotid stenosis is often diagnosed only after you have stroke symptoms. These symptoms will prompt your doctor to look for arterial blockages restricting blood flow. Doctors may even be able to hear a “bruit,” which is a slight whistle you can hear on a stethoscope placed against the neck. In either case, your doctor will follow up with testing.
Dr. Levitt says, “When you first come to the office with a diagnosis, we’ll meet you and answer questions. I’ll perform a complete history and physical, and if you haven’t had an ultrasound, we’ll get one. That’s just a probe that’s placed on the neck to look for a blockage.” The typical tests to confirm carotid stenosis include:
- Cerebral Angiography – a minimally invasive procedure that places a catheter into the arteries to get a closer look at a blockage
- Computed Tomography Angiography (CTA) – the injection of dye into your bloodstream which can be detected with imaging equipment to see inside the arteries
- Magnetic Resonance Angiography (MRA) – photographs your arteries without using X-rays
- Ultrasound – the use of sound waves to visualize the body’s interior
Dr. Levitt describes the typical process at Vascular Specialists of Central Florida, Inc. He says, “Once we have the ultrasound, if it does suggest you have a very high-grade blockage or narrowing of the artery, then the next step is usually to order a CT angiogram or a CAT scan with a dye injection. Then we can look objectively at how much narrowing you have. This all helps us determine your best treatment plan.”
Can You Prevent Carotid Stenosis?
Several contributing factors can put you at risk for carotid stenosis:
- A sedentary lifestyle
- High blood pressure
- High cholesterol
Even without these factors in your life, hereditary conditions and the natural aging process can also play a role in developing this condition. Dr. Levitt says, “The number one thing that people need to do is to quit smoking.”
For patients struggling with vascular issues, Vascular Specialists of Central Florida, Inc. offers a team of specialists who are dedicated to treating your body’s network of arteries and veins.
Speak with our team today to begin your journey to better health.