Carotid Artery Stenosis

Carotid Endarterectomy Surgery & Carotid Artery Stenosis Treatment

What Is Carotid Artery Stenosis?

Carotid artery stenosis is a condition where the main arteries on either side of the neck (carotid arteries) become clogged with plaque—a buildup of fatty cholesterol deposits. This condition reduces or blocks blood flow to the brain and can lead to stroke.

There are two carotid arteries, and either or both may be affected. The disease often develops without symptoms and progresses until a stroke occurs.

Symptoms of Carotid Artery Disease

The primary symptom is often a stroke or transient ischemic attack (TIA), also known as a “mini-stroke.”

Common symptoms include:

Drooping on one side of the face
Slurred or unclear speech
Vision loss in one eye (like a black curtain falling)
Numbness or weakness on one side of the body
Difficulty interacting or forming words

Causes and Risk Factors

Primary cause: Atherosclerosis (hardening of the arteries due to plaque buildup)

Risk factors:

Smoking
Diabetes
High blood pressure
High cholesterol or triglycerides
Age
Family history of stroke
Alcohol or recreational drug use
Neck trauma

Diagnosis

Carotid artery stenosis is often diagnosed after a stroke or TIA. Diagnostic tools include:

Physical exam (bruit or murmur in the neck)
Ultrasound
Computed Tomography Angiography (CTA)
Cerebral Angiography
Magnetic Resonance Imaging (MRI)

Classification:

Mild: <50% blockage
Moderate: 50–79% blockage
Severe: 80–99% blockage

Treatment Overview

Goals:

Improve brain blood flow
Prevent strokes
Slow disease progression

Non-Surgical Options:

Lifestyle changes: Diet, exercise, quit smoking, reduce salt
Medications: Aspirin, cholesterol-lowering drugs, blood pressure control

Surgical Treatments

1. Carotid Endarterectomy (CEA)

A surgical incision is made to remove plaque from the artery.
Typically recommended for severe blockage (70–99%) or if symptoms like TIA/stroke are present.
Requires general anesthesia.

2. Carotid Artery Stenting (CAS)

A less invasive procedure using a catheter and balloon to expand the artery.
A stent is placed to keep the artery open.
Used in high-risk surgical patients.

Factors Affecting Treatment Cost in India

Medication costs
Treatment duration
Hospitalization and room category
Location of hospital
Diagnostic test frequency
Medical tourism packages
Doctor’s experience and specialization
Type of procedure (CEA vs. CAS)
Government subsidies or health schemes

Conclusion

Early diagnosis and management are crucial. Even if symptoms aren't present, screening and monitoring are essential for at-risk individuals. Lifestyle changes, medication, and timely surgery can reduce the risk of stroke and improve overall outcomes.

Frequently Asked Questions

Q: What percentage of blockage requires surgery?
A: Surgery is strongly recommended for 70–99% blockage, and may be considered for 50–69% blockage in symptomatic patients.

Q: How fast does carotid stenosis progress?
A: Progression is usually slow but faster in diabetics or smokers with >50% stenosis. Rescreening is advised every 1–2 years.

Q: What is the life expectancy after carotid artery surgery?
A: 5-year survival rate post-surgery is around 85.2%, compared to 92% in the general population.

Q: How serious is a blocked artery in the neck?
A: It can lead to stroke, cognitive decline, and even dementia if untreated.

Q: Can cognitive problems develop due to carotid stenosis?
A: Yes, mild cognitive impairment is common and may worsen over time without treatment.