Carotid artery stenosis is when the carotid arteries narrow. The carotid arteries are blood vessels on each side of the neck. They supply blood from the heart to the brain.
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Carotid artery stenosis is caused by the build-up of plaque in the arteries. This build-up is called atherosclerosis. Plaque is made of cholesterol, fat, and other substances.
Less common causes are problems in the carotid artery, such as:
- An injury or tear
- Arteritis (inflammation)
- A blood clot
- A tumor
Carotid artery stenosis is more common in men and people over 60 years old. Other things that raise the risk are:
- High blood pressure
- Problems with blood fat levels, such as:
- Narrowing of other arteries, such as:
- Aortic aneurysm—a weak, bulging vessel from the heart
There are usually no symptoms. When symptoms happen, they may be those of a stroke or a transient ischemic attack (TIA or mini-stroke). Symptoms may be:
- Short-term loss of sight in one eye, blurry or dim vision
- Weakness, numbness, or tingling of the face, arm, leg, or one side of the body
- Problems speaking
- Problems with balance or falling
- Loss of consciousness
- Nausea or vomiting
- Problems with thinking, understanding, or memory
The doctor will ask about symptoms and past health. A physical exam will be done.
Imaging tests will diagnose blood vessel problems. They may include:
The goal of treatment is to improve blood flow to the brain and prevent a stroke. Treatment depends on how severe the condition is. It also depends on if there are symptoms.
Treatment options may be:
- Medicines to:
- Thin blood
- Lower cholesterol
- Manage other conditions such as high blood pressure and diabetes—if present
- Lifestyle changes such as:
For severe plaque build-up, surgery may be needed, such as:
- Carotid endarterectomy—to clean the plaque from the artery
- Carotid angioplasty and stenting—a stent is inserted to keep the artery open
There are no guidelines to prevent carotid artery stenosis. However, certain risks may be lowered by:
- Regular physical activity
- Eating more fruits and vegetables and eating less salt and fat
- Not smoking
Not drinking alcohol, or drinking it in
- No more than 2 drinks per day for men
- No more than 1 drink per day for women
- Keeping other conditions under control. This includes high cholesterol, high blood pressure, and diabetes
American Heart Association http://www.heart.org
National Stroke Association http://www.stroke.org
Health Canada https://www.canada.ca
Heart and Stroke Foundation of Canada http://www.heartandstroke.ca
Baiu I, Stern JR. Carotid artery endarterectomy. JAMA. 2020;324(1):110.
Carotid artery stenosis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/carotid-artery-stenosis. Accessed August 31, 2021.
Carotid artery stenosis. RadiologyInfo website. Available at: https://www.radiologyinfo.org/en/info/carotidstenosis. Accessed August 31, 2021.
Carotid stenosis. EBSCO Nursing Reference Center website. Available at: http://www.ebscohost.com/nursing/products/nursing-reference-center. Accessed August 31, 2021
- Reviewer: EBSCO Medical Review Board Nicole Meregian, PA
- Review Date: 07/2021
- Update Date: 08/31/2021