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Carotid artery disease is a condition in which the carotid arteries become narrowed or blocked. When the arteries become narrowed, the condition is called carotid stenosis.
The carotid arteries provide the main blood supply to the brain. They are located on each side of your neck. You can feel their pulse under the jawline.
Carotid stenosis; Stenosis - carotid
Carotid artery disease occurs when sticky, fatty substances called plaque build up in the inner lining of the arteries. See also: Atherosclerosis (hardening of the arteries)
The plaque may slowly block or narrow the carotid artery or cause a clot (thrombus) to form more suddenly. Clots can lead to stroke.
Risk factors for blockage or narrowing of the arteries include:
Two uncommon conditions called Marfan syndrome and fibromuscular dysplasia (abnormal growth or development of the cells in the walls of carotid arteries) may also cause narrowing of the carotid arteries.
You may not have any symptoms of carotid artery disease.
Your health care provider will perform a physical exam. The health care provider may hear an abnormal sound called a bruit when using a stethoscope to listen to the blood flow in your neck.
A physical exam may also reveal clots in the blood vessels of the eye. If you have had a stroke or TIA, a nervous system (neurological) exam will reveal other problems.
The following tests may be done:
The following imaging tests may be used to examine the blood vessels in the neck and brain:
Treatment options include:
There are two invasive ways to treat a carotid artery that is narrowed or blocked. These procedures are done to prevent new strokes in people with large blockages.
Stroke is a leading cause of death in the United States. Some people who have a stroke recover most or all of their functions. Others die from the stroke itself or from complications. About half of those who have a stroke have long-term problems.
The major complications with carotid artery disease are:
Go to the emergency room or call the local emergency number (such as 911) as soon as symptoms occur. When having a stroke, every second of delay can result in more brain injury.
The following can help prevent a stroke:
Follow your doctor's treatment recommendations if you have high blood pressure, diabetes, high cholesterol, or heart disease.
Brott TG, Halperin JL, Abbara S, et al. American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, et al. 2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS guideline on the management of patients with extracranial carotid and vertebral artery disease: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American Stroke Association, American Association of Neuroscience Nurses, American Association of Neurological Surgeons, American College of Radiology, American Society of Neuroradiology, Congress of Neurological Surgeons, Society of Atherosclerosis Imaging and Prevention, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of NeuroInterventional Surgery, Society for Vascular Medicine, and Society for Vascular Surgery. Vasc Med. 2011;16:35-77.
Brott TG, Hobson RW 2nd, Howard G, Roubin GS, Clark WM, Brooks W, et al. Stenting verses endarterectomy for treatment of carotid-artery stenosis. N Engl J Med. 2010;363:11-23.