If you have been diagnosed with carotid artery disease (also known as carotid artery stenosis), you may be wondering what that means. Carotid artery disease is a condition in which the carotid arteries- the two large blood vessels that carry blood to your head and brain- become narrowed due to plaque build-up. This can lead to a number of serious health problems, including stroke. Treatment options for carotid artery stenosis include medication and surgery. In this blog post, we will discuss the symptoms of carotid artery disease and how it is treated.
What is Carotid Artery Disease?
Carotid artery disease refers to a problem in which the carotid artery, the big vessel on either side of your neck, becomes clogged. The culprit is plaque, a complex substance containing calcium, cholesterol deposits, smooth muscle cells, and fibrin, which may cause narrowing of the artery. The plaque may restrict blood flow to the brain or serve as a source of embolic debris, in which bits of plaque may dislodge and travel to the brain.
Either case may result in a stroke and even death. Carotid disease is part of polyvascular disease, in which patients are at risk for plaque buildup in several types of arteries, including the coronary arteries of the heart, and peripheral arteries of the legs.
Is Carotid Artery Stenosis a Common Disease?
According to the American Stroke Association, stroke is fifth on the list of ailments that result in death. Carotid artery stenosis is a condition that develops over time and may worsen as you get older. It’s estimated that 5% of people have carotid artery stenosis in the general population.
Symptoms of Carotid Artery Disease
A stroke can be caused by carotid artery disease icd 10. The form of stroke that is most often induced by plaque (or platelets that develop on plaque) is known as an “ischemic” stroke. The plaque that travels to the brain deprives a portion of your brain of blood supply, causing damage to brain tissue. Depending on the amount of brain tissue involved, the stroke may be tiny with slight symptoms or massive and life-threatening. Symptoms would include numbness or weakness of any part of the body, difficulty speaking, swallowing, or vision changes. These deficits may be permanent or resolve slowly with therapy as injured but not permanently damaged brain tissue recovers.
A transient ischemic attack (TIA) is often referred to as a “mini-stroke” that occurs when a small artery in the brain is temporarily blocked by a small piece of plaque or blood clot. Typically, there is no permanent damage at this point. A TIA may last minutes to hours and may involve temporary numbness or weakness of hands, arms, legs, or feet. Some patients experience facial numbness, difficulty speaking, or a temporary visual defect in which vision in one eye becomes dark for a period of time. Usually, all symptoms resolve, but this may be a warning of a more serious stroke to come. It’s critical to seek evaluation as quickly as possible in these situations to avoid a permanent stroke.
How is Carotid Artery Stenosis ICD 10 Diagnosed?
Carotid artery stenosis may be suspected during routine physical exams when your doctor hears a buzzing sound with a stethoscope over the neck. This is called a bruit, and it indicates turbulent blood flow that may signal a narrowing of the artery. An investigation on a non-emergency basis is appropriate. When a patient experiences symptoms of a TIA or more severe stroke, an immediate investigation is advised.
Ultrasound
Ultrasound is a non-invasive imaging technique that uses sound waves to generate an image of your internal body structures and also measures the velocity (speed) of blood flow. Ultrasounds are painless tests that are administered on the surface of your skin. They’re useful for determining how blood flows through your arteries and detecting any areas of plaque buildup or narrowing.
Computed Tomography Angiography (CTA)
Your doctor may take a detailed look at your carotid arteries with a CT scanner (computed axial tomography), which is an X-ray device that creates a high-resolution image of your internal organs. During this procedure, an intravenous dye containing iodine is given to provide pictures of any blockages. People who have pacemakers or stents from other diseases can use this.
Magnetic Resonance Angiography (MRA)
This procedure is very different from a CT scan and uses no x-rays. It is an imaging technique that relies on a magnetic field to temporarily align subatomic particles in your cells and generate detailed images of body structures. This technique may be used with or without intravenous contrast. This is helpful for patients who have an allergic history to iodine, which is used in the contrast material in x-ray studies.
Carotid Angiography
A catheter is inserted into an artery in a minimally invasive manner and iodinated contrast is given to image blood vessels and blockages. This test can clearly image all of the blood vessels in the brain. CT angiography and Magnetic Resonance angiography have largely replaced the need for this procedure.
How To Treat Carotid Artery Stenosis
First and foremost, the primary aim of treating carotid disease is to prevent a stroke. To recognize that carotid artery disease is part of polyvascular disease, it is imperative to evaluate any patient with the carotid disease for possible coronary artery disease and peripheral vascular disease as well, to preserve life and limb.
After reviewing a patient’s history of symptoms, the physical exam for signs of stroke, and any of the imaging studies, a recommendation is made regarding the treatment of carotid disease.
For mild to moderate disease without symptoms, the treatment plan includes a healthy diet, exercise, smoking cessation, blood pressure, cholesterol control, and taking a baby aspirin daily. All of this is helpful in preventing the further buildup of carotid plaque and stroke or the need for surgery. A follow-up (surveillance) ultrasound would then be planned every 6 months to a year in order to watch for progression of narrowing or the development of symptoms.
For severe narrowing, or in the presence of any symptoms of carotid disease, surgery is usually advised. Most patients are treated with carotid endarterectomy, a procedure completed under general anesthesia with complete removal of plaque and repair of the carotid artery. Most patients are discharged home after overnight observation. In rare cases, a stent is placed without removing plaque. The choice of procedure is determined by the vascular surgeon in accordance with the patient’s condition.
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Dr. Lawrence Schmetterer, M.D., F.A.C.S. is one of the most skilled and respected vascular surgeons in Youngstown and Warren, Ohio. He has an experience of over two decades as a physician and treats patients in Youngstown, Austintown, Boardman, and Salem, Ohio. Dr. Lawrence Schmetterer is famous for his expertise in treating thoracic, vascular, mediastinal, and other diseases, in addition to varicose and other forms of veins.
