A carotid artery occlusion, or carotid artery stenosis, refers to the blockage of one of the carotid or neck arteries by plaque buildup or fatty deposits. In addition, carotid artery occlusion can either be classified as a partial occlusion or a complete blockage. Blocked carotids are major risk factors for heart attack and stroke. Other risk factors include smoking, high fat diet, genetics, and high blood pressure. In addition, diabetes, advancing age, obesity, and a family history of cardiovascular disease can contribute to carotid artery occlusion.
Although carotid artery occlusion can be asymptomatic, typical symptoms can include weakness, fainting, cognitive impairment, and difficulty with speech. In addition, the physician can usually suspect the presence of a blocked neck artery when he detects a swooshing sound called a carotid bruit while listening to the carotid artery with a stethoscope. Although a bruit does not confirm nor rule out the presence of a carotid artery occlusion, it can be cause for a referral for a carotid ultrasound. This test, known as a carotid duplex ultrasound uses sound waves to generate pictures of the carotid arteries, enabling the physician to further diagnose the condition. One of the most accurate tests for diagnosing this condition is the carotid angiogram where a catheter and x-rays are used to determine patency of the neck arteries.
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Treatment for carotid artery occlusion generally includes management of high blood pressure, treatment of high cholesterol with statin medications, and anticoagulant therapy such as aspirin or warfarin. Surgical management of a blocked carotid artery includes the carotid endarterectomy, which is the surgical excision of blood clots and fatty deposits from the walls of the carotid arteries. Carotid stenting is also used to restore blood flow by keeping the artery open and this procedure entails the application of a mesh device into the artery to keep it from collapsing. A stent works somewhat like scaffolding, because it supports the arterial walls and keeps them open.
Early diagnosis and intervention is important in the prognosis of a carotid artery occlusion. Prevention, however, is more important as it can prevent the occlusion from developing in many cases. Certain risk factors are not modifiable, such as family history and genetics, but patients can control some other risk factors. The physician needs to work with the patient to determine what treatment program is best for his situation, and how he can lower his risk for carotid arterial blockage and subsequent or cardiac event.