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How Carotid Artery Disease Increases Your Stroke Risk

Stroke is one of the leading causes of death and disability in the U.S., with someone suffering a stroke every 40 seconds. Unfortunately, these life-threatening medical emergencies generally occur with little or no warning.

One of the biggest culprits is carotid artery disease (also known as carotid artery stenosis), the buildup of fatty cholesterol deposits on the walls of one or both of the large carotid arteries found on either side of your neck. If this plaque is dislodged, pieces are carried to your brain, where they can block the flow of blood and oxygen.

It is estimated that as much as 5 percent of the U.S. population has some degree of carotid artery disease.

Symptoms of Carotid Artery Disease

What makes the condition so troublesome is that it exhibits little in the way of symptoms. You may have no obvious clues until you have a stroke or a transient ischemic attack (TIA). This minor stroke can occur when tiny pieces of plaque break free and create a temporary blockage before dissolving and moving on. The symptoms, which usually last less than five minutes,  include:

  • Weakness, numbness or paralysis on one side of your body
  • Slurred speech
  • Difficulty understanding written or spoken words
  • Blindness in one or both eyes
  • Dizziness
  • Severe and unexplained headache

These minor strokes serve as a red flag that a more significant event could be coming. If you have a TIA, your doctor will search for potential sources of blockage, often leading to a diagnosis of carotid artery disease through ultrasound or computed tomography (CT) scans of your neck. There are also instances when your doctor may notice an abnormal whistling sound, created by a blockage, while listening to your neck with a stethoscope.

Unlike with some other diseases (colon cancer and lung cancer, for example), there are no concrete guidelines for when, or even if, someone should be screened as a preventive measure. But, in general, you should be screened if you have two or more risk factors for the condition. The screening is a one-time thing unless there is evidence of plaque buildup. In that case, screenings could be needed as frequently as every six months.

Risk Factors for Carotid Artery Disease

A range of factors increase your risk for this disease. Some people are at higher risk because of factors outside their control, including family genetics. While rare, there are people who live a healthy and active lifestyle but still find themselves dealing with advanced cases of this disease. Other risk factors:

  • Smoking and using tobacco products
  • Obesity
  • Sedentary lifestyle
  • High blood pressure
  • High cholesterol
  • Diabetes
  • Age 50 or older

Treating Carotid Artery Disease

Treatment depends on the severity of your blockage. When the blockage is less than 50 percent, the disease is considered mild. Blockage of 50 percent to 69 percent is considered moderate, while anything over that is classified as severe.

If you fall in the mild or moderate group, treatment is typically medications. Often the combination of a daily aspirin and statin – used to control cholesterol– will do a great job of deterring future buildup and preventing existing plaque from breaking loose.

Once a patient reaches the severe stage, it’s often time to consider a preventive procedure to lower the risk of stroke. There are two common procedures used:

Carotid endarterectomy: This surgery involves making a small incision in the neck to get to the clogged artery. The surgeon then removes the plaque by cutting open the artery, which is then repaired. Once the procedure is done, it will last the rest of your life.

Stent: This procedure is a better option for patients who are not well enough to undergo surgery. Your doctor will place a large IV in your femoral artery and from the inside of your arteries place a reinforcing stent into the carotid artery in your neck. The stent forces the artery to return to its original size, while also trapping plaque against the artery walls. The potential downside of the procedure is a higher risk of causing a stroke or mini stroke.

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