Carotid Artery Disease: Diagnosis and Treatment
- Jul 19
- 3 min read
Infographic Summary:
Toledo Cardiology Consultants explains carotid artery disease, a condition where plaque buildup in the carotid arteries can restrict blood flow to the brain, potentially causing transient ischemic attacks (TIAs) or permanent strokes. The primary diagnostic tool is colour flow duplex ultrasound, though additional imaging like CTA or MRA may sometimes be needed. Treatment options range from medication alone to surgical interventions such as carotid endarterectomy or carotid stenting, all aimed at reducing stroke risk.
Toledo Cardiology Consultants explains carotid artery disease, a condition where plaque buildup in the carotid arteries can restrict blood flow to the brain, potentially causing transient ischemic attacks (TIAs) or permanent strokes. The primary diagnostic tool is colour flow duplex ultrasound, though additional imaging like CTA or MRA may sometimes be needed. Treatment options range from medication alone to surgical interventions such as carotid endarterectomy or carotid stenting, all aimed at reducing stroke risk.
​ Carotids Disease Diagnosis & Treatments ​ ​ Carotid Disease: ​ ​ Signs and symptoms: ​ The carotid artery is the large artery whose pulse can be felt on both sides of the neck under the jaw. On the right side it starts from the brachiocephalic trunk (a branch of the aorta) as the common carotid artery, and on the left side the common carotid artery comes directly off the aortic arch. At the throat it forks into the internal and external carotid arteries. The internal carotid artery supplies the brain, and the external carotid artery supplies the face. This fork is a common site for atherosclerosis, an inflammatory buildup of atheromatous plaque that can narrow the lumen (diameter) of the common or internal carotid arteries. The plaque can be stable and asymptomatic, or it can be a source of embolization. Emboli (solid pieces) break off from the plaque and travel through the circulation to blood vessels in the brain. As the vessel gets smaller, they can lodge in the vessel wall and restrict blood flow to parts of the brain which that vessel supplies. This ischemia (reduced blood flow) can either be temporary, yielding a transient ischemic attack, or permanent resulting in a thromboembolic stroke. Clinically, risk of stroke from carotid stenosis is evaluated by the presence or absence of symptoms and the degree of stenosis on imaging. Transient ischemic attacks (TIA's) are a warning sign, and are often followed by severe permanent strokes, particularly within the first two days. TIA's by definition last less than 24 hours (and usually last a few minutes), and frequently take the form of a weakness or loss of sensation of a limb or the trunk on one side of the body, or the loss of sight (amaurosis fugax) in one eye. Less common symptoms are artery sounds (bruits), or ringing in the ears (tinnitus). ​ Diagnosis: ​ ​ Carotid stenosis is usually diagnosed by colour flow duplex ultrasound scan of the carotid arteries in the neck. This involves no radiation, no needles and no contrast agents that may cause allergic reactions. This test has moderate sensitivity and specificity, and yields many false-positive results. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Typically duplex ultrasound scan is the only investigation required for decision making (including proce eding to intervention) in carotid stenosis. Occasionally further imaging is required. One of several different imaging modalities, such as angiogram, computed tomography angiogram (CTA) or magnetic resonance i
Clinically, the 30 day stroke or mortality rate after carotid endarterectomy is about 3 percent. Transient ischemic attacks by definition last less than 24 hours and are often followed by a permanent stroke within the first 2 days. Duplex ultrasound involves no radiation and no needles.
Carotid Disease Signs and Symptoms
See discussion above.
Diagnosis: Colour Flow Duplex Ultrasound
See discussion above.
Treatment: Medication, Endarterectomy, and Stenting
See discussion above.
Reducing Stroke Risk
See discussion above.
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