Carotid Artery Stenosis (CAS) Overview

Carotid Artery Stenosis (CAS) is a build-up of plaque made mostly of fat and cholesterol. The plaque causes the arteries to become stiff; this is commonly referred to as hardening of the arteries. When the arteries become obstructed, the blood is not able to flow freely to the brain, and the brain is deprived of oxygen, glucose, and other nutrients that are needed.

Carotid Artery Stenosis Causes

The function of the carotid arteries is to bring blood to your brain and a build-up of plaque, made up mostly of fat and cholesterol, can occur inside these arteries. The plaque causes the arteries to become stiff; this is commonly referred to as “hardening of the arteries.” When the arteries become obstructed, the blood is not able to flow freely to the brain, and the brain is deprived of oxygen, glucose, and other nutrients that are needed. Strokes can occur when the plaque ruptures and sends debris to the brain blocking the cerebral arteries, damaging the brain.

Carotid Artery Stenosis Risk Factors & Symptoms

Early carotid artery disease is usually asymptomatic. However higher degrees of stenosis can present as full stroke or TIA “mini-stroke.” Remember FAST.

Facial movement, one side
Arm or leg sudden paralysis, or numbness
Speech absence, slurred or garbled
Time critical, call 911

Risk Factors

There are many risk factors for CAS; however, with three or more present, your risk is multiplied significantly.

Age – over age of 65
High blood pressure
Diabetes
Smoking
High cholesterol
Obesity
Lack of Exercise
Family history of hardening of the arteries and/or stroke
Poor diet
Consuming more than 2 alcoholic drinks per day

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Carotid Artery Stenosis Diagnosis

Diagnosing CAS can be done with a non-invasive duplex ultrasound examination, which is the best and most effective test to determine your risk and the severity of the disease. If you experience symptoms of stroke, contact your primary care doctor right away and be evaluated.

Carotid Artery Stenosis Treatment

Treatment options vary depending on the severity of the disease found within the patient. Lifestyle changes are the easiest, least invasive, and can be an effective means of managing the disease. With appropriate medications, lifestyle changes, and yearly ultrasound monitoring, one may avoid a surgical intervention in mild to moderate disease. If the carotid disease is severe, surgical or “stent” therapy would be considered to reduce the chance of stroke. If a stroke or TIA – mini-stroke has occurred, interventional or surgical therapy will often be required.

Carotid Endarterectomy is performed to open and clean out the carotid artery to prevent stroke.
Carotid Stenting is a procedure in which a vascular surgeon inserts a slim mesh tube called a stent into the artery to expand the artery walls and increase the blood flow in the blocked artery.
TCAR – Transcarotid Artery Revascularization begins with a small incision made just above the collarbone to allow access to the carotid artery. A sheath is then placed in the carotid artery to protect the brain from debris during the procedure. The circuit directs blood flow and debris away from the brain while a stent is placed to exclude the blockage.

Carotid Artery Stenosis Prevention

Preventative measures can be taken to prevent or slow the disease progression. With additional lifestyle adjustments one can also decrease progression:

Stop smoking
Maintain a healthy weight
Limit the amount of fat and cholesterol in your diet
Eat more fruits and vegetables
Limit your intake of salt
Exercise regularly
Limit alcohol intake
Manage chronic conditions such as diabetes & high blood pressure

As always, if you are experiencing any of the warning signs for CAS, seek medical help immediately.

Carotid Artery Stenosis Progression

Early carotid artery disease is usually asymptomatic. Higher degrees of stenosis can present as a stroke or a mini-stroke. This includes transient blindness in one eye, weakness or numbness of an arm or leg, paralysis of the face, or speech problems.

FAQs

How is CAS diagnosed?

A non-invasive Duplex Ultrasound examination is typically the most effective test to determine your risk and the severity of carotid artery disease. If you experience carotid artery symptoms suggestive of a stroke, it’s crucial to contact your primary care doctor for an evaluation.

What are my treatment options?

Carotid artery stenosis treatment options include:

Carotid endarterectomy – a surgical procedure to open and clean out the carotid artery to prevent stroke.
Carotid stenting – a procedure where a vascular surgeon inserts a stent into the artery to widen it and improve blood flow in the blocked area, which can be relevant in cases of internal carotid artery stenosis or even bilateral carotid artery stenosis.
TCAR – Transcarotid Artery Revascularization (TCAR) involves a small incision above the collarbone for carotid artery access. A sheath protects the brain from debris while blood flow is temporarily redirected during stent placement to bypass the blockage.

Learn More About Carotid Artery Stenosis Treatment Options

What are some common indicators of carotid artery stenosis, and are there different types?

Common carotid artery symptoms can sometimes include transient ischemic attacks (TIAs) or even stroke. There are different ways to describe the condition based on the location and extent of the narrowing, such as internal carotid artery stenosis, which specifically affects the internal carotid artery, or bilateral carotid artery stenosis, where both carotid arteries are narrowed. Recognizing these potential symptoms are important for seeking timely diagnosis and treatment.

Carotid Artery Stenosis (CAS) Overview

Carotid Artery Stenosis (CAS) Overview

Carotid Artery Stenosis Causes

Carotid Artery Stenosis Risk Factors & Symptoms

Risk Factors

Carotid Artery Stenosis Diagnosis

Carotid Artery Stenosis Treatment

Carotid Artery Stenosis Prevention

Carotid Artery Stenosis Progression

FAQs

You have a choice when it comes to vascular care. Get an appointment at VIC in 1 to 3 days - without a referral!

You have a choice when it comes to vascular care. Get an appointment at VIC in 1 to 3 days - without a referral!

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