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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
doctor taking woman's blood pressure to see if she's at risk for carotid artery stenosis

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
woman with diabetes testing her blood sugar

At VIC, You Don’t Have to Wait 6-8 Weeks to See Us. Our Providers Will See You In 3 to 5 Days – Without a Referral!

At VIC, You Don’t Have to Wait 6-8 Weeks to See Us.
Our Providers Will See You In 3 to 5 Days – Without a Referral!

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
healthy salad to prevent carotid artery stenosis

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

A non-invasive Duplex Ultrasound examination 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, and be evaluated.

Carotid endarterectomy – a surgical procedure performed to open and clean out the carotid artery to prevent stroke

Carotid stenting – 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 (TCAR) 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.

Learn More About Carotid Artery Stenosis Treatment Options