Carotid artery disease affects the neck arteries that supply blood to the brain. It is dangerous because it is often silent in its early stages and can significantly increase stroke risk. However, with awareness, proper screening, and medical guidance, risk can be reduced.
In this article, the vascular specialists at Michigan Vascular Center review:
- What the carotid arteries are and the crucial role they play in brain health
- What carotid artery disease is and how it increases stroke risk
- How ultrasound screenings can detect problems early and save lives
- What treatment may look like if intervention is needed
- Expert tips for protecting your carotid arteries
What Are Carotid Arteries?
The carotid arteries are major blood vessels located on each side of the neck. As they travel upward, they branch into the internal and external carotid arteries. The internal carotid arteries carry blood to the brain and eyes. The external carotid arteries supply blood to the face, scalp, neck, and mouth.
Unlike many veins, carotid arteries do not have valves to prevent backward blood flow. They rely on heart rate and arterial wall elasticity to keep blood flowing smoothly. If plaque builds up inside the arteries, blood flow can become restricted. This narrowing, called carotid artery disease or stenosis, can cause serious complications, including stroke, if left unmanaged.
What Is Carotid Artery Disease?
Carotid artery disease, also called carotid artery stenosis, happens when cholesterol, calcium, fatty deposits, and other materials build up as plaque inside the carotid arteries. Over time, plaque buildup narrows the arteries and can limit blood flow to the brain. It also makes it easier for blood clots to form.
Many people don’t have obvious carotid artery disease symptoms until blood flow to the brain is already affected. In fact, for some, the first warning sign is a transient ischemic attack, or TIA, sometimes called a mini-stroke.
The Role of Carotid Arteries in Brain Health: How Carotid Artery Disease Causes Stroke
The carotid arteries carry oxygen-rich blood, glucose, and other nutrients to brain regions involved in thinking, movement, speech, vision, and other essential functions.
When the carotid arteries are open and healthy, blood flows easily, but if plaque builds up, the arteries narrow, slowing blood flow and increasing the risk of a blood clot. If a clot or a plaque fragment breaks off and blocks a smaller brain artery, it can cause a stroke.
Carotid artery disease does not always cause a stroke, but it is a significant and often silent risk factor. Early detection with a carotid ultrasound screening is crucial for stroke prevention.
Common Risk Factors for Carotid Artery Disease
Carotid artery disease can affect anyone, but it is more likely in people with certain risk factors that damage blood vessels or cause plaque to build up over time.
People at higher risk may include those with:
- High blood pressure
- High cholesterol
- A history of smoking
- Diabetes
- Older age, especially after 65
- A family history of vascular disease or heart disease
- Obesity or low physical activity
- A prior TIA or stroke
Detecting Carotid Artery Disease Before a Stroke: How Carotid Ultrasound Screenings Save Lives
Because carotid artery disease often develops without symptoms and you cannot detect narrowing by feeling your pulse or looking at your neck, vascular screenings are crucial for stroke prevention. A carotid ultrasound, also called a non-invasive Doppler test, is the most widely used modern screening tool.
Carotid artery ultrasound is non-invasive, painless, and fast. It doesn’t require needles, incisions, or radiation to take images. Instead, a small handheld device glides over the skin above the carotid arteries, using sound waves to assess blood flow, detect plaque buildup, and measure the degree of narrowing. If issues are detected, a vascular specialist can decide the next step to reduce a person’s risk of stroke.
Carotid Artery Disease Treatment: Medical Management vs Surgery
The goal of carotid artery disease treatment is always stroke prevention. The treatment approach depends on the degree of arterial narrowing, the presence of symptoms, age, surgical risk, and the patient’s medical history and overall health.
Not everyone with carotid artery disease needs surgery. For some, medications for carotid artery disease and/or close monitoring may be enough. Others may require a procedure to improve blood flow to lower stroke risk.
When Surgery or Minimally Invasive Treatment Is Recommended for Carotid Artery Stenosis
If you are a candidate for surgery, a vascular specialist may advise a surgical procedure or minimally invasive treatment if you have a severe blockage, especially if ultrasound imaging shows a higher risk for future blockage, or if you have recently experienced symptoms of a stroke.
The latest surgical and minimally invasive treatments for carotid artery stenosis include:
- Carotid Endarterectomy: An open vascular procedure used to remove plaque from the inside of the carotid artery. This has long been considered a standard treatment for select patients with significant carotid artery narrowing, especially when the narrowing has already caused symptoms.
- Carotid Artery Stenting: A minimally invasive endovascular procedure that places a mesh tube (stent) inside the carotid artery to help keep it open and improve blood flow. Stenting may be used for select patients who are not ideal candidates for open surgery or when a vascular specialist determines stenting is the better option.
Advanced carotid artery disease treatment is not one-size-fits-all. The right approach depends on the degree of narrowing, symptoms, overall health, and imaging results.
Medical Management of Carotid Artery Without Surgery
For some, surgery is not the first step, especially if narrowing is mild, there are no symptoms, and there is no personal or family history of stroke or vascular problems.
In these cases, stroke risk can often be managed with close medical care, which may include:
- Blood pressure control
- Cholesterol management
- Diabetes management
- Smoking cessation
- Ongoing vascular monitoring
- Lifestyle changes
- OTC or prescription medications
Medical management strategies are often combined in a long-term plan to reduce stroke risk. A vascular specialist can help find the best plan for you.
Living With Carotid Artery Disease: Long-Term Outlook and Daily Habits to Protect Your Carotid Arteries
While carotid artery disease is usually not fully reversible once significant stenosis develops, many people live full, active lives with proper management. Life expectancy depends on the severity of narrowing, symptoms, overall health, treatment adherence, and willingness to make sustained lifestyle changes.
Lifestyle changes cannot guarantee life expectancy or fully reverse carotid artery disease, but they can help lower the risk of plaque buildup, stroke, and other blood vessel problems.
Daily habits that support carotid artery health include:
- Quitting smoking
- Controlling blood pressure and cholesterol
- Managing blood sugar and diabetes
- Eating a heart-healthy diet
- Staying physically active with physician guidance
- Maintaining a healthy weight
If you have vascular system risk factors, annual vascular screenings and a carotid ultrasound are also important. If you already have a vascular condition, see a vein specialist regularly to monitor changes.
Carotid Artery Disease and Stroke FAQs
Is carotid artery disease the same as PAD?
Carotid artery disease and PAD are both types of arterial disease often caused by atherosclerosis and share risk factors such as smoking, high blood pressure, high cholesterol, and diabetes. However, they are not the same. Carotid artery disease affects the neck arteries that bring blood to the brain and raises stroke risk. PAD affects arteries in the arms or legs, most often the legs.
How is carotid artery disease different from coronary artery disease?
Carotid artery disease affects blood flow to the brain, while coronary artery disease affects blood flow to the heart. Both are often caused by atherosclerosis, which can affect arteries all over the body, including the aorta. That is why signs such as aortic calcification may prompt doctors to assess your overall vascular health.
What is the difference between carotid artery disease and renal artery stenosis?
Both conditions are types of arterial disease typically driven by atherosclerosis (plaque buildup), but they affect different arteries and organs. Carotid artery disease affects the blood flow to the brain, presenting a severe risk for stroke. In contrast, renal artery disease restricts blood flow to the kidneys, leading to severe hypertension and potential kidney failure.
Does a CT Scan Show a Blocked Carotid Artery?
A standard CT scan might show signs of a stroke, but it usually doesn’t give enough detail about blood flow in the carotid arteries to detect a blocked artery. To see narrowing or blockages, doctors may order a CT angiogram (CTA). However, a carotid ultrasound is often preferred in stroke prevention because it is non-invasive, does not use radiation or contrast dye, and can measure blood flow.
Can you check for a carotid artery blockage at home?
No. The only way to know if you have an artery blockage is to see a vein specialist for evaluation and a carotid artery ultrasound. The best thing a patient can do is recognize the warning signs of a stroke, such as sudden weakness, facial drooping, trouble speaking, vision changes, dizziness, or confusion, and call 911 immediately.
What are the first signs of a blocked carotid artery?
Most people do not have early warning signs. The first sign is often a TIA (mini stroke) or a stroke, which can cause sudden weakness, facial drooping, trouble speaking, vision changes, dizziness, or confusion.
What percent of carotid artery blockage is dangerous?
Any blockage can be dangerous if it is significant enough to affect blood flow to the brain, but a narrowing of 70% or more is usually the most concerning. That said, a number doesn’t tell the whole story. To determine individual stroke risk, a vascular specialist will also evaluate imaging results, the location of the narrowing, symptoms, medical history, and overall health.
Which artery is affected by a brain stem stroke?
A brainstem stroke does not involve the carotid arteries. It affects the vertebrobasilar arteries, primarily the basilar and vertebral arteries. However, those with carotid artery stenosis (plaque buildup in the carotid arteries) are statistically more likely to have matching plaque buildup simultaneously developing inside their vertebral and basilar arteries, putting them at a s higher risk for a brainstem stroke.
What does carotid artery disease ICD-10 mean?
ICD-10 is a medical coding system used for records and billing. If you see an ICD-10 code for carotid artery disease, ask your doctor or insurance provider what it means for your visit or diagnosis.
Stroke Prevention in Michigan | Michigan Vascular Center
Carotid artery disease often develops without warning, but early detection can lower your risk of stroke. At Michigan Vascular Center, in addition to testing and treating venous conditions and diseases, we specialize in stroke-prevention services, including non-invasive carotid artery ultrasound.
If you have been diagnosed with or have risk factors for a vascular condition, or have experienced signs of carotid artery disease, contact us for a vascular consultation. Our vascular specialists can evaluate your symptoms, perform the appropriate screening, and help determine your next step.
