Carotid atherosclerosis

Carotid stenosis is a progressive narrowing of the two major arteries carrying blood from the heart to the brain in a process called atherosclerosis, which is a buildup of plaque inside the artery that reduces the flow of blood to the brain. This is also known as coronary artery disease (CAD).

Normal arteries that are healthy have smooth inner walls and are flexible. As we age, injuries to the blood vessel wall or hypertension allow plaque to build up. Plaque is sticky and made up of fat, calcium, cholesterol, and other fibrous material.

Atherosclerosis can begin in early adulthood, but it usually takes decades to cause symptoms. Plaque deposits will progressively get larger inside the walls of the artery and eventually form a large mass, narrowing the lumen, or the diameter inside of the artery. Eventually, atherosclerosis causes a "hardening of the arteries," where they are rigid and inflexible.

Symptoms

Atherosclerosis can begin in early adulthood, but can take decades to cause symptoms.

Some individuals may begin to have rapidly progressing atherosclerosis during their thirties, while others won’t see symptoms until their fifties or sixties.

Unfortunately, the initial symptom of carotid atherosclerosis tends to be a transient ischemic attack (TIA), or a mini-stroke.

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A TIA occurs when blood flow is temporarily interrupted to the brain and then restored.

Even though it may not seem serious, TIAs should never be ignored as they are typically a warning sign for ischemic strokes, which cause permanent brain damage.

Symptoms of an ischemic stroke and TIA include difficulty speaking, drooping on one side of the face, visual disturbances, weakness or numbness in an arm or leg on one side of the body, or one-sided paralysis.

With a TIA, these symptoms will typically resolve completely after a couple of minutes and the person will return to normal.

Carotid artery disease can lead to stroke through:

  • Reduced blood flow
    a narrowing of a carotid artery by atherosclerosis that causes inadequate blood flow to supply your entire brain.
  • Ruptured plaques
    a piece of a plaque can break off and, when flowing to smaller arteries in your brain, get lodged in a smaller arteries, creating a blockage that blocks to flow of blood to parts of your brain.
  • Blood clot blockage
    some plaques are prone to cracking and will cause artery walls to have irregular surfaces. Your body treats these irregularities as injuries, sending blood cells to the area to help with the clotting process. This can result in a large clot that can cause a stroke after blood flow to the brain is slowed or stopped completely.

Risk Factors and Treatment

Risk factors for carotid artery disease include diabetes, high blood pressure, smoking, obesity, CAD, a family history of carotid stenosis, older age, and high low-density lipoprotein (LDL) cholesterol.

By addressing these risk factors, you can lowers your chances of developing carotid atherosclerosis.

Treatment of carotid stenosis involves reducing stroke risk by removing or controlling plaque buildup while preventing blood clots.


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Types of coronary stents: