6 Must-Know Facts About Carotid Stenosis

In my 17 years of practice as a vascular surgeon in Vadodara, I’ve encountered countless cases of carotid artery stenosis, each with its unique story and challenges. 

Whether you’re here out of concern for yourself or a loved one, understanding this condition can be life-saving. 

Let’s walk through the six must-know facts about carotid stenosis, and I’ll provide some insight into diagnosis, treatment, and preventive measures that could make all the difference.

Fact 1: What is Carotid Stenosis?

Carotid stenosis is the narrowing of the carotid arteries, which are the major vessels on each side of your neck. They are responsible for carrying oxygen-rich blood from your heart to your brain.
When plaque builds up in these arteries, it causes a condition known as carotid artery disease or stenosis. Over time, this plaque hardens, causing blockages that restrict blood flow. The consequences can be severe, as restricted blood flow to the brain can lead to a stroke.
Studies show that carotid stenosis contributes to about 15% of all ischemic strokes globally, highlighting the importance of early detection and treatment. Many people often mistake this condition for normal aging, but it’s crucial to recognize it as a health risk requiring attention.

Fact 2: Causes and Risk Factors

Much like wear and tear on an old bridge, our arteries can experience wear, particularly if they’re put under stress by certain lifestyle habits or conditions. Risk factors for carotid artery stenosis include:

• Age: The risk increases with age, particularly after 60.
• High cholesterol and hypertension: These can cause plaque buildup.
• Smoking: Accelerates arterial damage.
• Diabetes: Doubles the risk of carotid stenosis.
• Family history of cardiovascular diseases.

Preventing carotid stenosis starts with addressing these risk factors, as genetics alone don’t determine your fate. I often advise patients to prioritize a balanced diet, regular exercise, and routine check-ups – small changes that can make a big impact on heart and vascular health.

Fact 3: Symptoms and When to See a Doctor

Carotid artery stenosis is often silent. Many patients don’t know they have it until they experience transient ischemic attacks (TIAs)—commonly known as mini-strokes—or even full-blown strokes. Common carotid artery stenosis symptoms include sudden weakness, trouble speaking, blurred vision, and numbness, usually on one side of the body. Although most times they are temporary and resolve in a short time, they are often a warning sign of an underlying major blockage. 

It’s important to recognize these signs and consult a specialist promptly. As I tell my patients, “Don’t wait until the river runs dry.” 

Seeking advice from a vein specialist doctor near you at the onset of symptoms is crucial for timely diagnosis and intervention.

Fact 4: Diagnosis Methods for Carotid Stenosis

Diagnosing carotid stenosis typically involves a carotid Doppler ultrasound. This non-invasive test measures blood flow through your carotid arteries and can detect any blockages. It’s often the first step in identifying stenosis, and with accuracy rates above 90%, it’s a reliable starting point.

Other tests, like CT angiography or magnetic resonance angiography (MRA), may be used to get a clearer view. These imaging techniques allow us to determine the severity of the blockage and form an effective treatment plan. In some cases, a combination of tests is used to confirm the diagnosis and decide on the best course of action. If the blood vessels are highly calcified, one may need to further undergo a Digital subtraction angiography or DSA

Fact 5: Treatment Options Available

There’s no one-size-fits-all solution for carotid stenosis. Treatment depends on the degree of blockage, the presence of symptoms, and overall health. Here’s a look at the main carotid artery blockage treatment options:

1. Medications: For less severe cases, medications to control blood pressure, cholesterol, and blood-thinning agents are often the first line of defense.
2. Carotid Endarterectomy (CEA): This surgical procedure removes plaque buildup and is recommended for patients with moderate to severe blockage. It will be usually recommended only if the blockage is more than 70%, which is when the benefits are much more than the risk involved in surgery.
3. Carotid Artery Stenting (CAS): A stent is placed to widen the artery, which is particularly beneficial for patients who may not be good candidates for surgery. In this, we additionally use a cerebral protection filter to prevent embolisation of small plaque particles to the brain during the procedure.

Early treatment can make a profound difference, significantly reducing the risk of stroke. Each patient’s journey is unique, and a thorough consultation with a vascular specialist is essential to tailor the treatment approach.

Fact 6: Importance of Choosing an Experienced Vascular Surgeon

Carotid stenosis is complex and requires precise treatment. Selecting an experienced vascular surgeon can be the difference between life and death. Expertise ensures accurate diagnosis and effective treatment, especially in high-stakes procedures like endarterectomy and stenting.

In my own practice, I emphasize comprehensive, individualized care. Experience, combined with a commitment to patient education, makes for the best outcomes. I encourage patients to ask questions, understand their options, and make informed decisions about their health.

Preventative Measures for Carotid Stenosis

Preventing carotid artery stenosis isn’t just about avoiding certain foods or habits – it’s about creating a lifestyle that protects your heart and vessels. Here are some practical steps you can take:

• Maintain a heart-healthy diet: Reduce intake of saturated fats and opt for fruits, vegetables, and whole grains.
• Quit smoking: Smoking is one of the leading contributors to plaque buildup.
• Exercise regularly: Aim for at least 150 minutes of moderate exercise per week.
• Control blood pressure and cholesterol: Routine check-ups help catch these issues early.

Small changes can add years to your life, sparing you from the devastating effects of a stroke.

Conclusion

Carotid stenosis may be a silent condition, but it’s far from harmless. Knowledge, prevention, and early intervention are your best allies in keeping your carotid arteries – and by extension, your brain – in optimal health. 

As a vascular surgeon, my goal is not only to treat but also to empower patients to understand their health and make proactive choices.

In the end, think of your body as a car – a machine that needs regular maintenance. Just as you wouldn’t ignore a check engine light, don’t ignore your body’s signals. Be vigilant, seek expert guidance, and remember: prevention is always better than cure.

FAQ