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Carotid stenosis; Stenosis - carotid; Stroke - carotid artery; TIA - carotid artery
Carotid artery disease occurs when the carotid arteries become narrowed or blocked.
The carotid arteries provide part of the main blood supply to your brain. They are located on each side of your neck. You can feel their pulse under your jawline.
Carotid artery disease occurs when fatty material called plaque builds up inside the arteries. This buildup of plaque is called hardening of the arteries (atherosclerosis).
The plaque may slowly block or narrow the carotid artery. Or it may cause a clot to form suddenly. A clot that completely blocks the artery can lead to stroke.
Risk factors for blockage or narrowing of the arteries include:
At early stages, you may not have any symptoms. After plaque builds up, the first symptoms of carotid artery disease may be a stroke or a transient ischemic attack (TIA). A TIA is a small stroke that doesn't cause any lasting damage.
Symptoms of stroke and TIA include:
Your health care provider will perform a physical exam. Your provider may use a stethoscope to listen to the blood flow in your neck for an unusual sound called a bruit. This sound may be a sign of carotid artery disease.
Your provider also may find clots in the blood vessels of your eye. If you have had a stroke or TIA, a nervous system (neurological) exam will show other problems.
You may also have the following tests:
The following imaging tests may be used to examine the blood vessels in the neck and brain:
Treatment options include:
You may have certain procedures to treat a narrowed or blocked carotid artery:
Because there are no symptoms, you may not know you have carotid artery disease until you have a stroke or TIA.
Major complications of carotid artery disease are:
Go to the emergency room or call the local emergency number (such as 911) as soon as symptoms occur. The sooner you receive treatment, the better your chance for recovery. With a stroke, every second of delay can cause more brain injury.
Here's what you can do to help prevent carotid artery disease and stroke:
Biller J, Ruland S, Schneck MJ. Ischemic cerebrovascular disease. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 65.
Brott TG, Halperin JL, Abbara S, 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. Catheter Cardiovasc Interv. 2013;81(1):E76-E123. PMID: 23281092 www.ncbi.nlm.nih.gov/pubmed/23281092.
Meschia JF, Bushnell C, Boden-Albala B, et al. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45(12):3754-3832. PMID: 25355838 www.ncbi.nlm.nih.gov/pubmed/25355838.
Meschia JF, Klaas JP, Brown RD Jr, Brott TG. Evaluation and management of atherosclerotic carotid stenosis. Mayo Clin Proc. 2017;92(7):1144-1157. PMID: 28688468 www.ncbi.nlm.nih.gov/pubmed/28688468.BACK TO TOP
Review Date: 6/23/2019
Reviewed By: Alireza Minagar, MD, MBA, Professor, Department of Neurology, LSU Health Sciences Center, Shreveport, LA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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