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A carotid artery on each side of the neck supplies blood to the brain. Carotid artery disease occurs when a substance called plaque builds up in either or both arteries. The buildup can narrow the artery and reduce the blood flow to your brain. This can raise your chance of a stroke or transient ischemic attack (TIA).
The narrowing in an artery is called stenosis. The more narrow an artery becomes, the greater the risk of stroke or TIA.
Plaque can build up in your carotid arteries over time. Plaque may form because:
Many people have no symptoms. For some people, a transient ischemic attack (TIA) or stroke is the first sign of the disease.
If you have any of these symptoms of a TIA or stroke, call 911 or other emergency services right away.
Your doctor may listen to your neck for a sound called a bruit (pronounced "broo-EE"). This whooshing sound is often heard when a carotid artery is narrowed (stenosis).
If your doctor thinks you may have stenosis, you will have a Doppler ultrasound. This test uses sound waves to show how blood flows through an artery or vein. You also may have a CT angiogram or a magnetic resonance angiogram (MRA).
Routine tests for carotid artery disease are not recommended for everyone. Experts recommend them only for people who have symptoms.footnote 1
The goal of treatment is to lower your risk of a transient ischemic attack (TIA) or a stroke. Treatment depends on whether you have symptoms and how much of your arteries are blocked. You probably will take medicine. You also will be encouraged to make healthy lifestyle changes. Some people have procedures to lower their risk.
You will likely take aspirin or another medicine to prevent blood clots. You will likely also take medicine to lower cholesterol.
Work with your doctor to manage other health problems, such as high blood pressure and diabetes.
Avoid colds and influenza (flu). Get the flu vaccine every year.
Heart-healthy lifestyle changes can help lower your risk of stroke.
If you have some stenosis-but you don't have symptoms-your doctor may want you to have routine ultrasounds. This is to see if the narrowing in your arteries is getting worse.
Surgery in the arteries is called carotid endarterectomy. The doctor makes a cut in the neck and takes the plaque out of the artery.
Some people have a procedure called stenting. A doctor threads a thin tube through an artery in the groin and up to the carotid artery in the neck. Then he or she uses a tiny balloon to enlarge the narrowed part of the artery and places a stent to keep the artery open.
Surgery and stenting have a risk of serious problems, such as stroke or heart attack. People who are at increased risk for problems from surgery or stenting include those who have severe heart disease or other serious health problems. You and your doctor can decide together if you should have a procedure.
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CitationsU.S. Preventive Services Task Force, et al. (2021). Screening for asymptomatic carotid artery stenosis: US Preventive Services Task Force recommendation statement. JAMA, 325(5): 476–481. DOI: 10.1001/jama.2020.26988. Accessed April 21, 2020.
Current as of: April 29, 2021
Author: Healthwise StaffMedical Review: E. Gregory Thompson MD - Internal MedicineMartin J. Gabica MD - Family MedicineAdam Husney MD - Family MedicineRobert A. Kloner MD, PhD - Cardiology
Current as of: April 29, 2021
Author: Healthwise Staff
Medical Review:E. Gregory Thompson MD - Internal Medicine & Martin J. Gabica MD - Family Medicine & Adam Husney MD - Family Medicine & Robert A. Kloner MD, PhD - Cardiology
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