Carotid Artery Stenosis- Diagnosis, Evaluation and Treatment

Carotid artery stenosis is the narrowing of carotid arteries on both sides of the neck that carry blood to the brain, face, and head. A condition called atherosclerosis builds up plaque within the arteries and decreases the blood flow, which causes carotid artery stenosis. If ignored, stenosis can lead to a stroke because it completely narrows the arteries that carry blood to the brain. 

Risk Factors of Carotid Artery Stenosis 

These factors increase the risk of developing carotid artery stenosis:

• Age
• Sedentary lifestyle
• Smoking
• Diabetes
• High blood pressure
• Obesity 

Symptoms of Carotid Artery Stenosis

Some people with this condition may experience blurred vision, fainting, and dizziness, which indicate insufficient blood supply to the brain. Generally, the first sign of carotid artery stenosis is a stroke or transient ischemic attack (TIA) due to a blood clot in the blood vessel affected by atherosclerosis. When this clot gets dislodged, it can travel to the brain and plug up a smaller artery. This can be life-threatening. It can damage the section of the brain that is dependent on the blood vessel.

Symptoms of both a stroke and a TIA include:
Sudden numbness or paralysis (often on one side of the body)

• Confusion 
• Trouble speaking
• Trouble in comprehending speech
• Headache 
• Memory loss 

TIA is a temporary occlusion of a small artery that lasts a few minutes without causing any lasting damage. However, it is considered a warning sign of carotid artery stenosis. A stroke causes permanent injury to the part of the brain due to a lack of blood supply, resulting in severe disability or death. 

Diagnosis and Evaluation

Your doctor will analyze your medical history and conduct a physical examination. The physical exam often includes listening for an abnormal sound in the damaged artery. Your doctor may then assess your mental and physical capacities, including memory, strength, and speech. 

Doctors generally perform these tests to diagnose your condition:

• Computed Tomography Angiography (CTA)
  This test uses a CT scan to provide clear and detailed pictures of your carotid arteries. It helps the doctor analyze the severity of the stenosis. It is usually recommended for patients with stents and pacemakers.
• Magnetic Resonance Angiography 
  This test uses MRI instead of a CT scan to detect even small clots or strokes in the brain.
• Cerebral Angiography (Intra-Arterial Digital Subtraction Angiography)
  This minimally invasive procedure allows your doctor to view the blood flow in your arteries in real-time. Your doctor uses a catheter that guides them through the artery and then injects a contrast material through the tube to capture images with X-rays. 
• Carotid Ultrasound (Doppler Ultrasound)
  This non-invasive technique uses high-frequency sound waves to take images of the carotid arteries. Doppler ultrasound detects an artery’s restricted blood flow areas. 

Treatment for Carotid Artery Stenosis

Your doctor may recommend any of the following treatments depending on your health and severity of the condition.

• Carotid Endarterectomy 
  For severe cases of carotid artery stenosis, carotid endarterectomy is recommended. It is performed under general anesthesia. During the procedure, your surgeon makes an incision on your front neck to remove plaque or a damaged portion of the artery. After, the artery is repaired with a graft or stitches.
• Carotid Artery Angioplasty and Stenting 
  This treatment is recommended if the blockage is difficult to reach with carotid endarterectomy or if you have health conditions that may complicate your surgery. It is performed under local anesthesia. Your surgeon will make an incision in the groin and thread a catheter to the blockage site. A balloon is then inflated to widen the artery, and a stent is placed to keep it open. 

Contact or schedule an appointment with our vascular health experts at North Atlanta Vascular Clinic and Vein Center today if you need the treatment for carotid stenosis in Johns Creek. You can also get in touch with us for any questions about vascular disease.