A blocked carotid artery is one of the most common reasons for stroke in the United States of America. Every year about 750,000 new stroke cases take place in the United States out of which more than 20% are directly associated with the carotid artery blockage.
Vascular diseases reduce the life of a patient if they survive the first stroke. The life expectancy with blocked carotid artery reduces massively and the risk of surgery becomes inevitable. According to the Clinicast surgery can increase the life expectancy but it does narrow down to about 70%.
What is Carotid artery disease?
Carotid artery disease also known as carotid stenosis is a disease that can lead to an adult patient experiencing a stroke or a transient ischemic attack (ministroke or TIA). Carotid artery disease is basically caused by the arteries of the neck.
Maximum patients suffering from carotid artery disease are said to be asymptomatic. These patients might suspect a noise, a bruit in the back of the neck during a physical examination.
What causes a blocked carotid artery?
There can be several causes of a blocked carotid artery. A history of previous strokes, coronary bypass, myocardial infarction, angioplasty PVD, or extensive smoking. These people are most likely to suffer from carotid disease even though they remain asymptomatic.
Diagnosis of blocked carotid artery
The blocked carotid artery or if a person is suffering from a carotid artery disease can easily be checked through a carotid duplex ultrasound.
A simple non-invasive ultrasound can determine the level of blockage of a carotid artery or the plague within the carotid arteries. A primary care physician should talk to you about having a carotid ultrasound if he wants to determine whether you are suffering from blocked carotid artery disease or not.
One of the major reasons of carotid artery disease is a myocardial infarction which should be evaluated timely to reduce the risk of a fatal stroke.
Relationship between a carotid artery disease and a stroke
There can be various reasons for a stroke but carotid artery blockage comprises about 20 to 25% in adults.
Patients who suffer from a stroke, have about a 30% chance of experiencing a follow-up stroke against those who are suffering from a carotid artery disease.
They might suffer from another stroke within the first few weeks after recovering from the initial stroke, therefore, it becomes almost mandatory for a person who has just recovered from a stroke to get himself tested and checked for a blocked carotid artery.
The most lethal thing about a carotid disease is that there are no symptoms which makes it more difficult to determine whether a stroke was caused because of it or not.
After the age of 65, almost 50% of the carotid arteries are narrowed by themselves and this phenomenon is present in about 2 to 4 percent, however, it is not necessary that people will suffer from a stroke if the carotid arteries are narrowed by 50%.
Most people who suffer from stroke will not have any prior symptoms or a warning. Unfortunately, there are no symptoms of carotid artery disease, therefore, the only way to find the connection between a stroke and carotid stenosis is through carotid duplex ultrasound.
If for instance, the carotid duplex ultrasound reveals that a person is suffering from a carotid artery stenosis then the risk of the next stroke and an ultimate death increase. The risk level of stroke increases with the intensity of the degree of the carotid artery stenosis
Risk of carotid stenosis with age
As a person grows older, the risk of stroke increases, as well as a person suffering from silent carotid stenosis, also increases. There are various reasons for this but some of the most common reasons are:
- The carotid arteries narrow down to about 50% as part of the aging process, this is completely normal.
- Once the carotid arteries have narrowed down between 50 to 70% then they are at an alarming stage and should be monitored as they have a low risk of stroke attached to them and careful monitoring can avoid it.
- If the carotid arteries have narrowed down by over 70% then the health condition is at high risk and the person should be in consultation with a physician. This stage should not be taken lightly.
People who have crossed the age of 60 are considered to be more prone to suffer from the carotid disease. The risk of blockage of the carotid artery increases if the person is also:
- Smoker
- Already suffers from coronary disease or PAD
- He has murmurs or bruit present on his neck
- He has a history of a ministroke or a stroke
Treatment for blocked carotid artery
There are many successful ways to treat a blocked carotid artery. They are mentioned below:
Carotid endarterectomy (CEA): The standard way of treating carotid artery stenosis. This is a procedure that has been practiced for over 50 years now.
It involves a small incision of about 4 to 6 inches in the neck that will expose the affected carotid artery to be cleaned out. The process is carried out under regional (block) anesthesia or general anesthesia depending on the preference of the patient or the general physician.
A patient needs to stay in the hospital for about 24 to 48 hours for this process. The pain after the treatment is very minimal and it is expected from the patient to return to his daily routine within a week.
Physicians can perform carotid endarterectomy on both asymptomatic and symptomatic patients after the diagnosis depending upon the degree of blockage.
Carotid artery stenting (CAS): This process is also in practiced by physicians across the world for more than 15 years to treat the blockage of a carotid artery.
This was initially used on the patients who were said to be at a risk after carotid endarterectomy.
Carotid artery stenting is also performed under anesthesia by puncturing the groin. A person stays in the hospital for about 24 hours and later on is back to his normal routine within the next 48 to 72 hours.
The complication rate is higher in this process as compared to the carotid endarterectomy.
Complications increase if the patient is above the age of 70 and also suffers from neurological illness. This is the mere reason carotid artery stenting is recommended for patients who have suffered from a stroke or have symptoms of being on the verge of a stroke. This treatment is not recommended for asymptomatic patients.
Final thought
Blockage of the carotid artery occurs because of atherosclerosis when the arteries start to narrow down on their own. This can be because of calcium, fatty stuff, or any other kind of waste product inside the artery. This disease is very similar to coronary artery disease and a blocked carotid artery can lead to a stroke.
Life expectancy with blocked carotid artery reduces immensely as this leads to the reduction of oxygen flow to the brain.
If you have a blocked carotid artery then you need to be very careful to avoid another follow-up stroke by changing your lifestyle and maintaining one that is healthier and safer compared to the previous one. Include exercise, a healthy balanced diet, and recreational activities in your life to avoid a heart illness that might shorten your life or make you suffer a painful death.
