Carotid artery stenosis, known as carotid artery blockage, is of vital importance. This main artery, which supplies the brain with oxygen and nutrients, can narrow due to arteriosclerosis. This condition leads to impeded blood flow to the brain.
As a result, serious health issues such as transient stroke, vision loss, and even death can occur. Early diagnosis plays a critical role in preventing these complications. Diagnosis, usually performed using Doppler and color ultrasound, requires more detailed radiological examinations as the condition progresses.
| Disease Name | Carotid Artery Blockage (Carotid Artery Disease) |
| Affected Areas | Carotid arteries in the neck |
| Causes | Atherosclerosis, high cholesterol, hypertension, smoking, diabetes, advanced age, genetic predisposition |
| Symptoms | Usually asymptomatic; in advanced cases, transient ischemic attack (TIA) symptoms: sudden vision loss, unilateral weakness, speech difficulty, dizziness |
| Diagnostic Methods | Carotid ultrasound, magnetic resonance angiography (MRA), computed tomography angiography (CTA), carotid angiography |
| Treatment Options | Lifestyle changes (diet, exercise), anticoagulant drugs, statins, carotid endarterectomy (surgery), carotid stenting (CAS) |
| Complications | Stroke, transient ischemic attack (TIA), heart attack, death |
| Prevention Methods | Healthy diet, regular exercise, smoking cessation, blood pressure and cholesterol control, diabetes management |
| Epidemiology | More common in individuals over 60, more frequent in men, prevalent in those with high cardiovascular risk |
Prof. Dr. Özgür KILIÇKESMEZ
Interventional Radiology / Interventional Neuroradiology
Carotid Artery Blockage Symptoms
Carotid artery blockage usually progresses silently in early stages. When the narrowing reaches a severe level, symptoms can intensify to require urgent intervention. These symptoms typically begin as a transient ischemic attack. As a result of blockage in the related artery, blood flow to the brain decreases and noticeable symptoms appear. These symptoms usually last a few minutes and then resolve spontaneously.
- Sudden vision loss or difficulty seeing
- Weakness in the face, arm, or leg; sometimes accompanied by tingling or numbness
- Difficulty walking, balance and coordination problems
- Sudden dizziness and confusion
- Difficulty speaking and understanding
- Severe headache, memory problems, difficulty swallowing
These symptoms resemble stroke signs but are temporary in a TIA. Since this condition can lead to more serious complications later, it is crucial to seek immediate medical help when suspicious symptoms occur. Carotid artery blockage symptoms should be regarded as warning signs.
Carotid Artery Blockage Risk Factors
Many factors play a role in the development of carotid artery blockage. Advanced age indicates natural changes in the arteries. Smoking has harmful effects on vascular health. Hypertension leads to stiffening and narrowing of arterial walls. Additionally, high blood lipid and cholesterol levels increase the risk of atherosclerosis.
- Advanced age
- Smoking
- Hypertension
- Elevated blood lipids and cholesterol levels
- Diabetes
- Obesity
- Sedentary lifestyle
- Family history of atherosclerosis, coronary artery disease, or carotid artery disease
Men under 75 are at higher risk compared to women. However, women over 75 carry a higher risk than men. Individuals with coronary artery disease are more likely to develop carotid artery disease.
Factors Causing Carotid Artery Blockage
Carotid artery blockage develops due to atherosclerosis, similar to coronary arteries. It begins with damage to the healthy, flexible, and smooth inner surface of the carotid artery. This damage leads to dangerous deposits in the arterial walls. The following factors particularly trigger these deposits:
- High cholesterol levels
- Obesity
- Smoking
These factors cause accumulation of harmful substances such as cholesterol debris, fatty materials, and calcific residues in the arterial wall. Over time, these deposits form atherosclerotic plaques, leading to arterial narrowing or blockage.
Arterial narrowing reduces blood flow to the brain. If this reduction reaches critical levels, brain functions are impaired and serious health problems occur. Stroke risk significantly increases in this case.
Diagnosis of Carotid Artery Blockage
Carotid artery blockage is detected using appropriate diagnostic methods. First, physicians evaluate the patient’s medical history and symptoms. Then, narrowed arteries are examined in detail, particularly using Doppler ultrasonography. This method is effective in visually and audibly detecting abnormalities in blood flow.
Color Doppler ultrasound provides more detailed information about blood flow speed and direction. For advanced cases, computed tomography angiography (CTA) or magnetic resonance angiography (MRA) is preferred. These techniques show the internal structure of narrowed arteries in three dimensions, providing more definitive results.
- Smoking must be discontinued immediately.
- Hypertension and diabetes should be continuously controlled.
- A balanced and healthy diet program should be followed.
- Efforts should be made to lose excess weight.
- Weekly exercise routines should be established.
- Alcohol consumption should be minimized.
- Regular health check-ups should be conducted and doctor’s recommendations strictly followed.
These steps are critical to prevent disease progression and protect against potential complications.
What to Know About MRA
Magnetic resonance angiography uses MRI technology to obtain detailed images of blood vessels and blood flow. This method is preferred especially for evaluating vessel patency and health.
No radiation is used when imaging the body via magnetic fields and radio waves, making MRA particularly safe. Offering a comfortable experience for patients, this examination is an effective method for diagnosing many vascular problems, including coronary artery diseases.
During the scan, patients lie on a specially designed table and enter the MRI tunnel. The process usually takes 15 to 20 minutes in various positions. Patients must remain still during the scan, as movement directly affects image quality.
Regarding contrast agents, gadolinium-based contrast agents may be administered in some cases for clearer images. This agent is used to distinguish vessel structures from surrounding tissues and make vessels more visible.
Preparations before the scan are generally minimal but include important points:
- Removal of metal objects: All metal items must be removed due to strong magnetic fields.
- Allergic reactions: Possible allergies to the contrast agent should be reported in advance.
- Food and drink: Fasting may be required if imaging the abdominal area.
MRA is an extremely low-risk and comfortable imaging method. Its cost may be more affordable compared to classic angiography methods. Also, since no catheter is used, catheter-related risks are avoided. Patients can return to their normal activities immediately after the scan. This method is increasingly preferred in cardiology as a modern imaging technique.
Details of Stent Application for Carotid Artery Blockage
The stenting procedure for carotid artery blockage is performed to restore normal blood flow to the brain. The patient remains awake during the procedure, with sedatives administered to ensure comfort. The procedure begins via the femoral artery and progresses using a specially designed thin catheter.
- At the start of the procedure, a guidewire is used to position the catheter correctly.
- The wire helps reach the blockage site.
- Next, a balloon catheter is placed in the artery for angioplasty.
- The balloon is inflated and deflated to expand the narrowed segment.
- Finally, a stent is placed to prevent re-narrowing.
These steps are meticulously applied to reopen the artery and restore blood flow. After the procedure, the patient typically rests for a short time and stays overnight in the hospital. If there are no complications, discharge occurs the next day.
Frequently Asked Questions
Carotid artery blockage can obstruct blood flow to the brain. This causes certain brain regions to become deprived of oxygen. Oxygen-deprived brain tissue can be damaged, leading to permanent paralysis. Additionally, if clots in the carotid artery break off and block cerebral vessels, sudden death can occur. Therefore, carotid artery blockage can have serious outcomes and may be fatal.
No, carotid artery blockage does not cause neck pain. It is a condition where blood flow to the brain is impeded, presenting various symptoms. These usually include numbness and weakness on the opposite side of the body from the blockage.
Prof. Dr. Özgür Kılıçkesmez graduated from Cerrahpaşa Medical Faculty in 1997. He completed his specialization at Istanbul Education and Research Hospital. He received training in interventional radiology and oncology in London. He founded the interventional radiology department at Istanbul Çam and Sakura City Hospital and became a professor in 2020. He holds many international awards and certificates, has over 150 scientific publications, and has been cited more than 1500 times. He is currently working at Medicana Ataköy Hospital.
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