Carotid Artery Disease

What is carotid artery disease?

Your arteries are responsible for delivering oxygen-rich blood from your heart to other parts of your body. Your carotid arteries are two main arteries that carry blood from your heart, up through your neck, to your brain.

Sherif SultanHealthy carotid arteries are smooth and unobstructed, allowing blood to flow freely to the brain and provide oxygen, glucose, and other nutrients that your brain cells need. Typically with age, the carotid arteries build up plaque, a sticky substance made up mostly of fat and cholesterol. Plaque narrows the passageway within the arteries and causes them to become stiff. Carotid artery disease results when the carotid arteries become too narrow or obstructed and limit the blood flow to the brain.

Strokes result either from obstruction of blood flow to the brain by the plaque or when bits of plaque and clots break off from the plaque and flow to the brain. If left untreated, carotid artery disease may lead to stroke. Depending on its severity, a stroke can be fatal. In fact, strokes are the third leading cause of death in Ireland and the leading cause of permanent disability in older adults.

Causes and risk factors

  • Age (45years and older)
  • Hypertension (high blood pressure)
  • Diabetes
  • Smoking
  • High cholesterol
  • Obesity
  • Lack of exercise
  • Family history of atherosclerosis (hardening of the arteries) and/or stroke
  • Irregular heartbeat, particularly atrial fibrillation (a diagnosed condition where the heart chambers quiver and beat ineffectively)

Symptoms and Warning signs

There may be no symptoms in the early stages of carotid artery disease, and stroke could be the first sign of the condition. Stroke, however, can have warning signs, referred to as mini-strokes or transient ischemic attacks. Mini-stroke symptoms are usually temporary, lasting a few minutes to a few hours, and should be treated as serious medical emergencies requiring immediate treatment because they are strong predictors of future stoke.

Some symptoms of stroke include:

  • Weakness, numbness, or tingling on one side of the body
  • Inability to control movement of a body part
  • Loss of vision or blurred vision in one or both eyes
  • Inability to speak clearly
  • Difficulty talking or comprehending what others are saying
  • Dizziness or confusion

Diagnosis

Diagnosis of carotid disease begins with a careful medical history, including risk factors and physical exam.

Doppler/Duplex Ultrasound: A technologist uses sound waves to make images of your carotid arteries (ultrasound). During the test a special ultrasound probe is gently pressed against your neck. An image then forms on a monitor the result shows how severe the narrowing is.

Other Imaging Tests Patients also have brain imaging performed such as CT scan, prior to surgery, that can show damage from a past stroke. Some patients will have get an injection of dye (contrast) during this CT scan to get a closer look at their carotid arteries. If dye is used it is called a CT Angiogram.

Carotid Videos

You can browse some of the videos of procedures that have been carried out by Mr. Sultan at the link below:

carotid procedures

References

  1. Lally C, Hynes N, Sultan S. Preclinical Medical Device Testing and the Potential of Non-Invasive Imaging Carotid Artery Intervention In High-risk Patients: Vascular 2008 16 (2) S103
  2. Hynes N, Sultan S. Carotid Artery Stenting (CAS) Under Neuro-protection, Carotid Endarterectomy (CEA) And Best Medical Therapy (BMT) for symptomatic patients with low Grey Scale Median (GSM). Vascular 2008 16 (2) S108:
  3. Sultan S. Contemporary Trends in Carotid Intervention: the 21st Century Approach to Carotid Endarterectomy, Carotid Artery Stenting under Neuro Protection and Optimal Medical Treatment Vascular 2008 16 (2) S108:
  4. Sultan S. Carotid stump syndrome. A case report and literature review. Int Angiol. 2004 Sep;23(3):284-7. Review. PMID: 15765045
 
The Western Vascular Institute
The Western Vascular Institute