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Carotid Artery Disease

What is carotid artery disease?

Carotid artery disease, also called carotid artery stenosis, occurs when the carotid arteries, the main blood vessels that carry oxygenated blood to the brain, become narrowed. The narrowing of the carotid arteries is most commonly related to atherosclerosis (a build-up of plaque, which is a deposit of fatty substances, cholesterol, cellular waste products, calcium, and fibrin in the inner lining of an artery). Atherosclerosis, or “hardening of the arteries,” is a vascular disease (disease of the arteries and veins). Carotid artery disease is similar to coronary artery disease, in which blockages occur in the arteries of the heart, and may cause a heart attack.

To better understand how carotid artery disease affects the brain, a basic review of the anatomy of the circulation system of the brain follows.

What causes carotid artery disease?

Atherosclerosis is the most common cause of carotid artery disease. It is unknown exactly how atherosclerosis begins or what causes it. Atherosclerosis is a slow, progressive, vascular disease that may start as early as childhood. However, the disease has the potential to progress rapidly. It is generally characterized by the accumulation of fatty deposits along the innermost layer of the arteries. If the disease process progresses, plaque formation may take place. Plaque is made up of deposits of smooth muscle cells, fatty substances, cholesterol, calcium, and cellular waste products. This thickening narrows the arteries and can decrease blood flow or completely block the flow of blood to the brain.

Risk factors associated with atherosclerosis include:

  • older age
  • male
  • family history
  • race or ethnicity
  • genetic factors
  • hyperlipidemia (elevated fats in the blood)
  • hypertension (high blood pressure)
  • smoking
  • diabetes
  • obesity
  • diet high in saturated fat
  • lack of exercise
Treatment for carotid artery disease:

Specific treatment for carotid artery disease will be determined by your physician based on:

  • your age, overall health, and medical history
  • extent of the disease
  • your signs and symptoms
  • your tolerance of specific medications, procedures, or therapies
  • expectations for the course of the disease
  • your opinion or preference

Carotid artery disease (asymptomatic or symptomatic) in which the narrowing of the carotid artery is less than 50 percent is most often treated medically. Asymptomatic disease with less than 70 percent narrowing may also be treated medically, depending on the individual situation.