Carotid Artery Stenosis

What Is Carotid Artery Stenosis?

Causes, Symptoms & Treatment

What Causes Carotid Artery Stenosis?

Carotid artery stenosis is primarily caused by atherosclerosis, a process in which fatty deposits (plaque) build up within the artery walls, leading to narrowing and reduced blood flow to the brain.

Key risk factors include:

• Smoking

• High blood pressure (hypertension)

• High cholesterol levels

• Diabetes

• Advancing age

• Family history of cardiovascular disease

Symptoms

Carotid artery stenosis often develops gradually and may not cause symptoms in its early stages.

In some cases, it may present as a Transient Ischaemic Attack (TIA) or “mini-stroke”, which is a warning sign of increased stroke risk.

Symptoms may include:

• Sudden weakness or numbness on one side of the body

• Difficulty speaking or understanding speech

• Sudden loss of vision in one eye

• Dizziness or loss of balance

These symptoms may be temporary, but should always be treated as a medical emergency.

Treatment Options

Treatment depends on the severity of the narrowing and the patient’s overall risk profile. The aim is to reduce the risk of stroke and improve blood flow to the brain.

Carotid Endarterectomy (CEA)

Carotid Endarterectomy (CEA) is a surgical procedure used to remove plaque from the carotid artery and restore normal blood flow.

The carotid arteries are the main vessels supplying blood to the brain, face, and neck, making this procedure highly effective in reducing stroke risk in appropriate patients.

Overview of the CEA Procedure

Before Surgery

Assessment & Planning

Your doctor will carry out a comprehensive evaluation, including your medical history and imaging tests such as:

• Carotid ultrasound

• CT angiography

• MR angiography

Preparation

You may be advised to:

• Temporarily stop certain medications

• Fast before the procedure

• Arrange transport and support following discharge

During Surgery

• Anaesthesia: Either general anaesthesia (asleep) or local anaesthesia with sedation

• Incision: A small incision is made along the side of the neck

• Plaque Removal: The artery is carefully opened, and the plaque is removed

• Closure: The artery is repaired

After Surgery

Recovery

Patients typically remain in the hospital for 1–2 days for monitoring.

Medications

You may be prescribed medications such as:

• anticoagulation (lixiana) agents (e.g., aspirin)

• Blood pressure medications

• Cholesterol-lowering therapy

Follow-Up

Regular follow-up appointments are important to:

• Monitor healing

• Assess blood flow

• Reduce the risk of recurrence

Outcomes

Carotid endarterectomy is a well-established procedure with strong evidence in reducing the risk of stroke in patients with significant carotid artery narrowing.