What Everyone Should Know About Carotid Artery Disease

Once you reach middle age, a basic carotid artery check may become part of your annual exam: Your primary care doctor may feel your pulse by gently placing their fingers on these major arteries in your neck, or they may use a stethoscope to listen for a whooshing sound (bruit), which suggests turbulent blood flow.

If your doctor notices anything concerning — especially if you have any significant risk factors for cardiovascular disease — they may refer you to Advanced Vascular Surgery for a preventive carotid duplex ultrasound screening.  

In this month’s blog, our team explains what everyone should know about carotid artery disease, a “silent” condition that dangerously raises your stroke risk without intervention. 

Keeping your brain supplied with oxygen

As the complex central command center for all cognitive and physical processes, your brain requires continuous oxygen delivery to stay healthy and functional. Even though it accounts for just 2% of your body weight, it consumes about 20% of your oxygen. 

Your brain receives most of its oxygen-rich blood through the carotid arteries — the two major arteries in your neck, situated on either side of your windpipe. 

When these vital arteries are healthy and clear, the blood flow to your brain is normal. Even when it’s narrowed slightly by early-stage plaque buildup (mild carotid stenosis), your brain still receives sufficient oxygen because your cardiovascular system prioritizes blood flow to your brain above all else. 

How atherosclerosis narrows your arteries

Carotid artery disease occurs when atherosclerosis — a buildup of sticky plaque deposits inside the walls of your blood vessels — narrows one or both of the arteries in your neck. 

Atherosclerosis-linked diseases are the leading cause of death worldwide. Coronary artery disease occurs when plaque narrows the main arteries of the heart; peripheral artery disease happens when it affects large arteries in your arms or legs. 

This fatty accumulation occurs gradually in five basic steps:

1. An area of the arterial wall sustains initial damage
2. Inflammatory cells travel to the site to initiate repair
3. Cell waste and cholesterol cluster over the damage
4. White blood cells ingest the cholesterol clusters
5. The cholesterol-eating cells form into sticky plaque  

The initial vascular damage may be from unhealthy habits, a medical condition, genetic influences, or a combination of factors. When the process occurs repeatedly over time, plaque layers accumulate — and the affected vessel becomes progressively narrower. 

Carotid artery disease is a silent danger 

Plaque buildup is unhealthy because it reduces blood flow to the affected area. It can become life-threatening when it builds to the point of total blockage, or when a plaque rupture forms a blood clot that fully blocks blood flow.  

This is what causes most heart attacks and strokes. 

When atherosclerosis affects your carotid arteries, your stroke risk increases significantly. Specifically, it raises your risk of suffering an ischemic stroke, which occurs when plaque or a blood clot stops the flow of blood and oxygen to your brain. In the United States: 

• Nearly nine in 10 strokes (87%) are ischemic in nature
• Someone suffers a major stroke every 40 seconds
• Someone dies from a stroke about every three minutes

Stroke is responsible for one in six cardiovascular-related deaths each year. For those who survive the event, permanent brain damage, lengthy rehabilitation, or a lifetime of disability are common outcomes. 

Carotid artery disease detection and care

Carotid artery disease is a “silent killer” because it doesn’t cause symptoms until it’s advanced. Often, the first sign of a plaque problem in the arteries that supply your brain is either a transient ischemic attack (TIA, or mini stroke) or a full-blown ischemic stroke. 

Risk factor guidance

We don’t want the problem to get that far. We can detect carotid artery disease with a simple preventive ultrasound screening, which we recommend for anyone with any of the following major risk factors:

• High blood pressure
• Current or previous smoker
• High cholesterol levels
• Older age; family history
• Overweight or obesity 
• Lack of physical activity

Type 2 diabetes is also a major risk factor: People with diabetes are four times more likely to develop carotid artery disease compared with those with normal blood sugar control.  

Interventional care 

If ultrasound testing shows plaque buildup in your carotid arteries, a combination of lifestyle changes and medical treatment can halt its progression, keep it stable, and protect your health. You may be advised to:

• Quit smoking cigarettes
• Exercise more regularly
• Choose healthier foods 
• Lose excess body weight

Medical management of carotid artery disease may involve taking a daily aspirin or other antiplatelet medication to reduce your risk of blood clots. Blood pressure control, cholesterol stabilization, and diabetes management are also essential. 

If you have a partial blockage in either artery, we may recommend a procedure, such as carotid endarterectomy or stenting, to clear the blockage and reduce your stroke risk. 

Worried about carotid artery disease? With offices in Kalamazoo, Allegan, Battle Creek, Coldwater, Sturgis, and Three Rivers, Michigan, our team at Advanced Vascular Surgery is here to help. Call or click online to schedule your visit today.