Many patients do not show any symptoms and the stenosis is discovered on a routine medical exam as the physician listens with a stethoscope to the blood flowing through the artery.
If there are symptoms, they will depend on which carotid artery is involved. Some patients may experience a transient ischemic attack (TIA). TIA's are usually characterized by blurred vision or a brief loss of vision in one eye, slurred speech, numbness or weakness on one or both sides of the body, paralysis and loss of consciousness resulting from insufficient blood flow to the brain. These symptoms are often a sign of a more serious cerebral accident and must be treated immediately to prevent a major stroke.
Besides the observable symptoms mentioned above, there are four imaging studies that are used to diagnose carotid stenosis. They are:
Carotid ultrasound: A noninvasive test that uses ultrasound to create an image of the artery when narrowing of the carotid arteries due to plaque buildup is suspected. It is often the first test used on a patient being evaluated for surgery to reopen a blocked artery. Duplex scanning is a technique that measures blood flow at many points in the blood vessel at one time.
Carotid arteriogram: Arteriography, also known as angiography, is a blood-flow test. Dyes are injected into the blood vessels and an X-ray is taken to produce a picture of the blood flow through the vessels.
Magnetic imaging angiogram (MRA): MRA uses a magnetic field and radio waves to create detailed computer images of blood vessels and is able to distinguish healthy tissue from diseased tissue.
Computed tomography angiogram (CTA): During a CTA scan, a special dye is injected into a vein in the arm to highlight the blood vessels and makes them easier to see on the scanned images. The CT scanner uses a thin X-ray beam and advanced computer analysis to create highly detailed images.
Causes and Risk Factors
Increased risk factors for carotid stenosis are:
- Elevated cholesterol levels
- Age (men under 75 years old and women older than 75)
- Family or personal history of coronary artery disease or carotid artery disease
- High blood pressure
- Inactivity or sedentary lifestyle
One of the primary risks associated with carotid stenosis is increased susceptibility for stroke.
No physician can predict with certainty whether a patient will suffer a stroke due to the narrowing of the carotid arteries. It is thought that arteries that contain jagged or unstable plaques are more likely to dislodge and when they do, restrict blood flow to the brain, causing a stroke. With stroke being the third leading cause of death in the United States and carotid stenosis accounting for approximately 50 percent of those deaths, medical intervention at the first suspicion of a stroke is essential.