Carotid Artery Disease (CAD)

You have two arteries in your neck, taking blood from your heart to your brain.  Disease inside these arteries occurs when you get a buildup of waxy plaque.   Symptoms & Surgical treatments for CAD

What are Carotid Arteries?

The carotid arteries are located in the neck on each side of the windpipe.  They provide important blood flow to the head including the brain.  Normally, these arteries have a smooth lining but in diseased vessels, owing to the formation of cholesterol plaque a narrowing develops.  This results in deranged blood flow and dislodgement of plaque and other debris, a process called embolisation, that can travel to the brain causing a stroke or transient ischaemic attack (TIA).

A stroke occurs when blood flow to a part of the brain is restricted causing brain cells to die.  This may be owing to pressure from bleeding (cerebral haemorrhage) or blockage of an artery in the brain (cerebral infarction). The latter can be caused by carotid artery disease from embolisation or severe restriction of blood flow to the brain.

Symptoms of Carotid Artery Disease

  • Asymptomatic carotid stenosis
    Narrowing of the carotid artery may be silent but the risk of stroke is still present, although this risk is small if it is managed, ie high cholesterol is treated, usually by taking a medication called a statin, a mild blood thinner, like low-dose aspirin, is prescribed, and high blood pressure and diabetes are controlled.
  • Amaurosis fugax
    Temporary blockage to the blood flow of the retina (back of the eyeball) results in transient blindness.  This appears as a dark curtain coming across the eye and may last for minutes to hours. It is usually a sign of embolisation from the carotid artery.
  • Stroke or TIA
    Temporary blockage to the blood flow of a part of the brain can result in the following symptoms which resolve within 24 hours:

    • Speech difficulty
    • Visual loss
    • Weakness and/or numbness on one side of the body
    • Poor coordination

Patients with 70% or more narrowing are recommended to have what is called an endarterectomy.  This is a surgical procedure to open the artery and clean out the plaque, causing the narrowing. This significantly reduces your risk of stroke.