Carotid artery disease is a narrowing of the two arteries in the sides of the neck that carry blood to the brain, usually caused by atherosclerosis, and it can raise the risk of stroke. Carotid artery disease treatment includes medicines and control of risk factors, and some patients may need surgery to clean out the artery or a stent. Dr. Walid Naser assesses these cases in Amman.
Note: Sudden weakness or numbness of the face, arm or leg on one side, sudden trouble speaking or understanding, or sudden loss of vision in one eye are signs of a stroke or mini-stroke. Call an ambulance or go to the emergency department straight away, even if the symptoms go away.
Symptoms
Many people have no symptoms, and the narrowing may be found by chance. When symptoms appear, they may include:
- Sudden weakness or numbness on one side of the body.
- Sudden difficulty speaking or understanding speech.
- Brief loss of vision in one eye, like a curtain coming down.
- Sudden dizziness or loss of balance.
- Symptoms that go away within a short time (a transient ischaemic attack), which is an important warning.
Causes
The most common cause is plaque building up in the artery wall. Risk factors include:
- Smoking.
- High blood pressure.
- High cholesterol.
- Diabetes.
- Older age.
- Artery disease elsewhere, such as in the leg arteries or heart.
Diagnosis
Assessment starts with your history and an examination. Your doctor may request tests to find how narrow the artery is and what the plaque is like.
- Carotid Doppler ultrasound.
- CT or MR angiography.
- Brain imaging if you have had symptoms.
- Heart and risk-factor assessment with other doctors when needed.
Treatment options
Treatment depends on how narrow the artery is, whether you have had symptoms and your general health:
Deciding on a procedure means carefully weighing the expected benefit against the risks, and your doctor will discuss this with you in detail.
- Stopping smoking, a healthy diet and regular physical activity.
- Medicines prescribed by your doctor to control blood pressure, cholesterol and sugar and to lower the risk of clots.
- Regular Doppler follow-up in cases that do not need a procedure.
- Carotid stenting through a catheter in selected cases.
- Carotid endarterectomy: surgery through a small cut in the neck to remove the plaque.
What to expect on the day and after
Surgery or stenting is done in hospital, with close monitoring of brain function afterwards. Your surgeon will explain the anaesthetic and expected hospital stay in your case.
- Checks on speech, movement and blood pressure after the procedure.
- Care of the neck wound or puncture site.
- Taking your prescribed medicines.
- Going to the emergency department straight away if any new neurological symptom appears.
- Regular Doppler follow-up.
When to book an appointment
Book an appointment if:
- A doctor has told you that you have carotid narrowing.
- You had brief neurological symptoms, were assessed in the emergency department and were asked to see a vascular surgeon.
- You have artery disease elsewhere together with several risk factors.