Carotid Artery Disease

GENERAL INFORMATION:

What is carotid artery disease? Your carotid arteries are the blood vessels that supply your brain with most of the blood it needs to work. You have two carotid arteries, one on each side of your neck. Carotid artery disease is when one or both of the carotid arteries become narrowed or blocked.

What causes carotid artery disease? Carotid artery disease is caused by atherosclerosis (ath-er-oh-skle-ROH-sis), which is also called hardening of the arteries. Atherosclerosis is when fatty deposits and other things build up in an artery and form plaque. This plaque buildup is what narrows or blocks one or both carotid arteries. Plaque in the arteries also increases your chance of having dangerous blood clots. Blood clots can travel to different areas of the body and cause serious problems, such as a stroke.

Who is at high risk of getting carotid artery disease? You are more likely to develop carotid artery disease as you age. Males have carotid artery disease more often than females. Other things that increase your chance of having carotid artery disease include:

• Family history: You are more likely to have problems if atherosclerosis or stroke runs in your family.
  
  
• Heart disease: Atherosclerosis can cause narrowing of the arteries in the heart as well as the carotid arteries.
  
  
• Other health problems: You are more likely to have carotid artery disease if you have high blood pressure, high cholesterol (koh-LES-ter-ol), diabetes, or problems with blood circulation.
  
  
• Smoking: Smoking causes your arteries to narrow and decreases the amount of oxygen in your blood. Smoking also damages the walls of your arteries, which may allow blood clots to form. Smoking increases your risk of having a heart attack, stroke, and other serious health problems.

What are the signs and symptoms of carotid artery disease?

• Some people may have transient (TRAN-zee-ent) ischemic (is-KEE-mic) attacks, or TIAs. TIAs are also called "mini-strokes". With TIAs you may have numbness (loss of feeling), muscle weakness, or lack of movement on one side of the body. You may have problems with your vision or trouble talking. TIA symptoms usually last for a few minutes and go away completely within 24 hours.
  
  
• Many people with carotid artery disease do not have any symptoms. However, people with carotid artery disease usually have narrowing of the arteries elsewhere in the body. If you have heart disease or problems with your circulation, it may be a sign that you have carotid artery disease as well.

How is carotid artery disease diagnosed?

• Carotid bruit: When blood flows through a narrowed carotid artery, it often makes a loud "whooshing" noise. Your caregiver may hear this noise, called a bruit (BREW-eet), through a stethoscope placed on your neck.
  
  
• Carotid ultrasound: This is a simple test using sound waves to see your carotid arteries. This test helps your caregiver see narrowing or blood flow problems.
  
  
• CT scan: This test is also called a "CAT" scan. A special x-ray machine uses a computer to take pictures of the inside of your head and neck. This test can help caregivers see if your carotid artery disease has caused problems in the brain. Another CT test that may be done is called CT angiography (an-gee-OG-ruh-fee), which looks at your carotid arteries.
  
  
• Arteriography: Arteriography (ahr-te-ree-OG-rah-fee) is an x-ray test of the carotid arteries. A special dye is injected into an artery in your leg or arm. The dye helps the carotid arteries show up better in the x-ray pictures.
  
  
• Magnetic resonance angiography: Magnetic resonance (RES-oh-nans) angiography (an-jee-OHG-rah-fee) is also called a MRA test. This test uses a large magnet and radio waves to see images of your carotid arteries on a computer screen. Dye is injected into a vein so that the carotid arteries show up better in the pictures.

How is carotid artery disease treated? The treatment you receive depends on how narrow your arteries have become, your symptoms, and your general health. The goal of treatment is to lower your risk of having a stroke. You may receive the following treatments alone or together:

• Aspirin: Caregivers often suggest that you take an aspirin a day if you have carotid artery disease. Aspirin helps to prevent blood clots from forming in the carotid arteries. If caregivers want you to take aspirin daily, do not take acetaminophen (a-seet-a-MIN-oh-fen) or ibuprofen (eye-bu-PROH-fen) instead.
  
  
• Control risk factors: High blood pressure, high cholesterol, heart disease, diabetes, and being overweight increase your risk of atherosclerosis. Ask caregivers for help controlling these conditions. Also, smoking causes blockages in the arteries throughout your body in many different ways. With time, this can cause a stroke or a heart attack. It is very important to stop smoking.
  
  
• Carotid endarterectomy (en-dahr-ter-EK-toh-mee): An incision is made in the front of the neck into the carotid artery. The plaque is cut out of the artery, which gives the blood more room to flow. The artery is then sewn back together.
  
  
• Angioplasty and stenting: For this procedure, your caregiver makes a small puncture into an artery (usually in the groin area). A small wire with a balloon on the end is sent up into the carotid artery. The caregiver inflates the balloon to push the plaque against the artery wall and make more room for blood to flow. This process is called angioplasty (AN-jee-oh-plas-tee). Sometimes a stent is placed during an angioplasty procedure. A stent is a metal mesh tube that is placed in the artery to keep it open.

Risks:

• Carotid artery disease may increase your risk of having a stroke. A stroke (or "brain attack") happens when your brain is injured due to a lack of blood flow. A stroke can happen if a carotid artery becomes too narrow or blocked. Blood clots or plaque fragments from a carotid artery may travel to the brain and cause a stroke. A stroke is a serious medical condition and may even be life-threatening. People who have had one or more TIAs are also at higher risk of having a stroke.
  
  
• Carotid artery disease does not cause heart attacks. However, if you have carotid artery disease your risk of having a heart problem is high. This is because the atherosclerosis which caused your carotid artery disease may also narrow the arteries around the heart.

For more information: Contact the following organizations for more information about carotid artery disease, atherosclerosis, and stroke:

• • American Heart Association National Center
    7272 Greenville Avenue
    Dallas, TX 75231-4596
    Phone: 1-800-242-8721
    Web Address: http://www.americanheart.org
    
  
  
  
• • National Institute of Neurological Disorders and Stroke
    P.O. Box 5801
    Bethesda, MD 20824
    Phone: 1-800-352-9424
    Web Address: http://www.ninds.nih.gov
    

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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