June 25, 2012 | A stroke occurs when the blood supply to part of the brain is suddenly interrupted. The carotid arteries, which are located on either side of the neck, supply most of the oxygen-rich blood to the brain. The carotid arteries are particularly susceptible to the development of atherosclerosis, or “hardening of the arteries”, in which a fatty type of scar tissue, called plaque, forms inside the walls of the arteries and interferes with blood flow. Sometimes, blood clots form on the surface of the plaque. This is especially common if the plaque in an artery cracks or ruptures. Blood cells called platelets can stick to the site of the injury and may clump together to form blood clots. Blood clots can partly or fully block a carotid artery. A piece of plaque or a blood clot also can break away from the wall of the carotid artery. The plaque or clot can travel through the bloodstream and get stuck in one of the brain’s smaller arteries. This can block blood flow in the artery and cause a stroke.

June 25, 2012 | For some people, having a transient ischemic attack, or “mini-stroke,” is the first sign of carotid artery disease. During a mini-stroke, a patient may have some or all of the symptoms of a stroke. However, the symptoms usually go away on their own within 24 hours. The symptoms of a stroke are called the “four S’s” for speech, sight, strength or sensation. The symptoms may include sudden weakness or numbness in the face or limbs, trouble speaking or understanding speech, and sudden trouble seeing in one eye. Even if the symptoms stop quickly, it’s important to get checked and to get treatment started as soon as possible. Call 911, do not attempt to drive yourself to the hospital. A mini-stroke is a warning sign that you’re at high risk of having a stroke. You shouldn’t ignore these symptoms. About one-third of people who have mini-strokes will later have strokes. Getting medical care can help find possible causes of a mini-stroke and help you manage risk factors.

June 25, 2012 | Certain factors may raise your risk for carotid artery disease and stroke.  Smoking, hypertension, hypercholesterolemia, diabetes and family history are the most important risk factors. The more risk factors you have, the more likely you are to get the disease. Some factors, such as smoking, a lack of physical activity and a poor diet, you can control, but others you can’t, such as age. As you get older, your risk for carotid artery disease increases. Genetic or lifestyle factors cause plaque to build up in your arteries as you age. People who have diabetes are four times more likely to have carotid artery disease than people who don’t. With this disease, the body’s blood sugar level is too high because the body doesn’t make enough insulin or doesn’t use its insulin properly. Having any of these risk factors doesn’t guarantee that you’ll develop carotid artery disease. However, if you know that you have one or more factors, you can take steps to help prevent or delay the disease.

June 25, 2012 | In most cases, a physician can tell if you have carotid artery disease during a normal checkup. During the checkup, doctor may ask if you have had symptoms of a stroke, such as muscle weakness or numbness, lightheadedness, or trouble talking or seeing. By placing a stethoscope over the carotid artery in your neck, the doctor can listen for a rushing sound, called a bruit (PRONOUNCED “brew-ee”). But, the results of this test can be misleading. Bruit sounds may not always be present, even when carotid artery disease is severe. A common, noninvasive test used to check for carotid artery disease is a Doppler ultrasound. This variation of the conventional ultrasound assesses blood flow by bouncing high-frequency sound waves off red blood cells. If you do not have any risk factors for carotid artery disease, you do not need an ultrasound. But if you have risk factors, then your doctor may order this test which is extremely accurate and painless.

June 25, 2012 | The method used to treat carotid artery disease depends on how narrow the patient’s arteries have become. Dr. John Eidt, director of UAMS’ Division of Vascular Surgery, says that mild to moderate blockage may only require certain lifestyle changes, such as quitting smoking, managing your cholesterol, losing weight and getting exercise. Aspirin may be recommended to avoid the formation of dangerous blood clots. Patients with more severe blockage may need a procedure to prevent a stroke. A carotid endarterectomy, in which the plaque is removed from the artery, can be done under local or general anesthesia. Another treatment involves the use of stent to trap the debris and restore flow without surgery. UAMS is one of the leading centers in the U.S. in evaluating carotid endarterectomy and stenting, and Eidt says that he chooses the best procedure for each patient based on individual factors and that both treatments are effective in reducing stroke.