Carotid artery stenosis is the narrowing of the carotid arteries which provide much of the oxygen-rich blood supply to the brain. Atherosclerosis, or a buildup of fatty deposits called plaques within the arteries, is the leading cause of carotid artery stenosis. This condition may lead to a stroke--the permanent loss of brain cells caused by loss of blood supply in the affected area. Treatment for carotid artery stenosis depends of the severity of blood vessel narrowing, the presence of symptoms and the patient's overall health status.
Medication and Risk Factor Modification
Doctors generally use medications to treat patients with less than 50 percent narrowing of the carotid arteries and those with up to 70 percent narrowing and no symptoms, reports New York-Presbyterian Hospital. Antiplatelet medications, such as dipyridamole, clopidogrel and aspirin, decrease the likelihood of clot formation at the site of a carotid artery plaque. A blood thinner, or anticoagulant, can also decrease the risk of clot formation and stroke by disrupting the protein clumping that occurs with clot development. Cholesterol-lowering medication can help reduce the risk of plaque growth and further narrowing of the carotid arteries.
Smoking significantly increases the risk for a stroke. Patients with carotid artery stenosis can help lower their stroke risk by stopping smoking. Dietary changes and regular exercise may help correct an elevated blood cholesterol level, reducing the risk for carotid artery plaque growth.
Carotid Artery Angioplasty
The Texas Heart Institute reports that doctors may recommend a carotid artery angioplasty for patients with severe carotid artery stenosis or those who have brain-related symptoms caused by reduced carotid artery blood flow. The procedure involves inserting a narrow tube-like device, or catheter, into an artery in the leg and guiding it through the blood vessels to reach the diseased carotid artery. Inflation of a balloon at the end of the catheter squeezes the plaque against the artery wall to reduce artery blockage. Doctors typically place a small metal tube, or stent, at the site of the plaque to help keep the carotid artery open.
Carotid Endarterectomy
A carotid endarterectomy is a surgical procedure to remove a blood flow-obstructing carotid artery plaque. While the patient is under anesthesia, the surgeon opens the diseased carotid artery and removes the plaque to reestablish normal blood flow to the brain. Doctors commonly recommend a carotid endarterectomy to help prevent a stroke in patients with severe carotid artery stenosis or to reduce the risk of a second stroke in patients who have already suffered a carotid artery-related stroke. The National Institute of Neurological Disorders and Stroke reports that among patients with a 70 to 99 percent carotid artery blockage, carotid endarterectomy reduces the risk of a stroke or death by approximately 80 percent over a 2-year period.
References
- New York-Presbyterian Hospital: Carotid Artery Disease
- Texas Heart Institute: Carotid Artery Disease
- National Institute of Neurological Disorders and Stroke: Questions and Answers about Carotid Endarterectomy
- National Heart Lung and Blood Institute: Carotid Endarterectomy
- National Heart Lung and Blood Institute: Carotid Artery Disease
