Carotid Artery Stenosis: Causes, Symptoms, Treatment, and Cost

The narrowing of the carotid arteries, which provide oxygen-rich blood to the brain, is referred to as 'Carotid Artery Stenosis.' Typically, a buildup of plaque in the arteries is the source of this disorder, which may reduce blood flow to the brain and raise the risk of a stroke or other consequences.

There are two types of Carotid Artery Stenosis:

• Symptomatic Carotid Artery Stenosis: This type of stenosis causes symptoms such as transient ischemic attacks (TIAs), stroke, or amaurosis fugax (temporary vision loss).
• Asymptomatic Carotid Artery Stenosis: This kind of stenosis is often found by accident during normal medical examinations or imaging procedures since it has no symptoms.

Several factors can increase the risk of developing Carotid Artery Stenosis, including:

• High blood pressure: High blood pressure can damage the inner lining of the arteries, making it easier for plaque to accumulate.
• High cholesterol: High levels of LDL or 'bad' cholesterol in the blood can lead to the formation of plaque in the arteries.
• Smoking: Smoking can damage the inner lining of the arteries and increase the risk of plaque buildup.
• Diabetes: Diabetes can damage the blood vessels and increase the risk of atherosclerosis.
• Age: As people age, the risk of developing Carotid Artery Stenosis increases.
• Family history: People with a family history of Carotid Artery Stenosis are at increased risk of developing the condition.
• Obesity: Being overweight or obese can increase the risk of high blood pressure, high cholesterol, and diabetes, all of which are risk factors for Carotid Artery Stenosis.
• Physical inactivity: Lack of physical activity can contribute to the development of risk factors such as high blood pressure, high cholesterol, and obesity, increasing the risk of Carotid Artery Stenosis.

The symptoms of Carotid Artery Stenosis may include:

• The body has a weakness or numbness on one side.
• Difficulties speaking or understanding speech
• Vision problems, including double vision or loss of vision in one eye
• Unsteadiness or balance issues
• Terrible headache
• Swallowing difficulties Facial paralysis or drooping
• An earache that ringers (tinnitus)
• Chest pain or pressure.

Several methods can be used to prevent Carotid Artery Stenosis, including:

• Adopting a healthy lifestyle: This includes following a well-balanced diet that is low in fat, cholesterol, and salt, maintaining a healthy weight, and incorporating regular physical activity into your daily routine.
• Quitting smoking: Smoking can severely damage the arteries, increasing the likelihood of plaque buildup and narrowing of the carotid arteries.
• Controlling blood pressure: Maintaining healthy blood pressure is crucial since high blood pressure is a significant risk factor for Carotid Artery Stenosis.
• Managing diabetes: Diabetes can also increase the risk of Carotid Artery Stenosis, so it is important to manage blood sugar levels through medication, diet, and exercise.
• Taking medication: Certain medications, such as cholesterol-lowering drugs and blood thinners, may be prescribed to prevent the buildup of plaque in the carotid arteries and reduce the risk of stroke.
• Undergoing surgery: In severe cases of Carotid Artery Stenosis, surgery may be necessary to remove the plaque or widen the artery and improve blood flow.

Carotid Artery Stenosis is typically diagnosed through :

• Carotid ultrasound: This non-invasive test uses high-frequency sound waves to create images of the carotid arteries and check for the presence of plaque buildup.
• Magnetic resonance angiography (MRA): This is a type of imaging test that uses magnetic fields and radio waves to create images of the blood vessels, including the carotid arteries.
• Computed tomography angiography (CTA): This test uses X-rays and a contrast dye to create detailed images of the blood vessels, including the carotid arteries.
• Duplex ultrasound: This test combines traditional ultrasound with Doppler ultrasound to assess the blood flow in the carotid arteries and check for any narrowing or blockages.
• Angiogram: This invasive test involves inserting a thin, flexible tube called a catheter into a blood vessel in the groin and guiding it to the carotid arteries. A contrast dye is injected into the catheter, which helps create images of the arteries and identify any blockages.
• Physical examination: Your doctor may perform a physical exam to check for any signs of Carotid Artery Stenosis, such as a weak pulse in the neck or a whooshing sound when listening to the arteries with a stethoscope.

Carotid Artery Stenosis can lead to several serious complications, including:

• Stroke: The most serious complication of Carotid Artery Stenosis is stroke, which occurs when blood flow to the brain is blocked by a blood clot or plaque that has broken off from the carotid artery.
• Transient ischemic attack (TIA): A TIA, also known as a 'mini-stroke,' occurs when blood flow to the brain is temporarily interrupted, usually due to a blood clot or plaque. TIAs can cause symptoms similar to a stroke, but they typically last only a few minutes to a few hours.
• Aneurysm: Carotid Artery Stenosis can weaken the walls of the artery, leading to the formation of an aneurysm, which is a bulge in the wall of the artery. If the aneurysm ruptures, it can cause life-threatening bleeding.
• Cognitive decline: Reduced blood flow to the brain can lead to cognitive decline, including problems with memory, attention, and reasoning.
• Carotid artery dissection: This is a rare but serious complication of Carotid Artery Stenosis, which occurs when a tear develops in the inner lining of the artery, leading to the formation of a blood clot and reduced blood flow to the brain.
• Peripheral artery disease: Carotid Artery Stenosis is often associated with peripheral artery disease, which is a condition in which plaque accumulates in the arteries that supply blood to the legs and feet. This can lead to pain, numbness, and difficulty walking.

Remedies for Carotid Artery Stenosis:

• Garlic: Garlic has blood thinning properties and helps in improving blood flow to the brain. Chewing 2-3 cloves of garlic daily can help manage Carotid Artery Stenosis.
• Guggulu: Guggulu, a herb used in Ayurveda, helps the body decrease its cholesterol levels. It is available as pills, powders, or capsules for consumption.
• Turmeric: Turmeric contains anti-inflammatory qualities that may assist to lessen carotid artery irritation. You may drink it with warm milk or water.
• Ginger: Ginger helps in reducing blood pressure and improving blood circulation. You may drink it as tea or include it in your meals.
• Ashwagandha: An adaptogenic herb, ashwagandha aids in controlling the body's level of stress. It may be eaten as powder, pills, or capsules.
• Maintain a healthy diet: A diet rich in fruits, vegetables, healthy grains, and low in saturated fats may help manage Carotid Artery Stenosis.
• Exercise regularly: Regular exercise helps to improve blood circulation and decrease cholesterol levels.
• Quit smoking: A significant risk factor for Carotid Artery Stenosis is smoking. Reducing your chances of acquiring the disorder may be achieved by giving up smoking.
• Manage stress levels: Stress can increase blood pressure levels and contribute to the development of Carotid Artery
• Stenosis. Use relaxation techniques like yoga, meditation, or deep breathing. Sleep well: A good night's sleep is important for overall health and can help in managing Carotid Artery Stenosis. Sleep for 7-8 hours every night.

These foods must be preferred if you have Carotid Artery Stenosis:

• A diet rich in fruits and vegetables, whole grains, and lean proteins such as fish and chicken is recommended for individuals with Carotid Artery Stenosis.
• Foods high in omega-3 fatty acids, such as salmon, tuna, and flaxseed, may be beneficial in reducing inflammation and lowering cholesterol levels.
• Low-fat dairy products such as skim milk, yogurt, and cheese can provide calcium and vitamin D without adding excess saturated fat to the diet.
• Nuts and seeds, such as almonds and chia seeds, may provide fiber and good fats.
• Limiting salt intake may decrease blood pressure and reduce the risk of stroke.
• Drinking plenty of water and avoiding sugary drinks can also promote overall health and reduce the risk of obesity and diabetes.

When suffering from Carotid Artery Stenosis, the following foods should not be eaten:

• High-fat meat and dairy products: These foods significantly increase the body's cholesterol levels, which might lead to plaque buildup in the arteries, particularly the carotid arteries.
• Fast food and processed snacks: These foods are high in sodium and unhealthy fats, which can increase blood pressure and contribute to plaque buildup in the arteries.
• Sugary drinks and high-sugar foods: Consuming sugary drinks and foods can increase blood sugar levels, which has been linked to an increased risk of Carotid Artery Stenosis.
• Fried and greasy foods: These types of foods are high in trans fats, which have been linked to an increase in LDL cholesterol levels and a decrease in HDL cholesterol levels, which can contribute to plaque buildup in the arteries.
• Alcohol: Drinking alcohol in excess can lead to an increase in blood pressure and can contribute to the formation of blood clots, which can increase the risk of stroke in people with Carotid Artery Stenosis.

The following techniques may be used to treat Carotid Artery Stenosis:

• Endarterectomy: Endarterectomy is a surgical procedure that involves removing the buildup of plaque from the inner surface of the carotid artery. This is typically recommended for patients with severe Carotid Artery Stenosis, or when medical management alone is not enough to prevent stroke.
• Angioplasty and stenting: Carotid Artery Stenosis may also be treated using less invasive techniques like angioplasty and stenting. A little balloon is put into the problematic artery during this surgery, and it is inflated to widen the constricted space. Moreover, a stent may be inserted to maintain the artery open.

Cardiologist: A cardiologist is a medical professional who specialises in the identification and management of diseases of the heart and blood vessels. They may evaluate the Carotid Artery Stenosis risk factors, including high blood pressure and excessive cholesterol, and provide medical care to lower the risk of stroke.

Here are some common medications used to treat Carotid Artery Stenosis:

• Antiplatelet drugs: These drugs help prevent blood clots from forming in the carotid arteries, reducing the risk of stroke. Examples include aspirin, clopidogrel, and ticlopidine.
• Anticoagulants: These drugs also help prevent blood clots, but they work by inhibiting the clotting proteins in the blood. Examples include warfarin and heparin.
• Statins: These drugs help lower cholesterol levels in the blood and reduce the buildup of plaque in the carotid arteries. Examples include atorvastatin, simvastatin, and rosuvastatin.
• Blood pressure medications: These drugs help lower blood pressure, which can reduce the risk of complications associated with Carotid Artery Stenosis. Examples include angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, and calcium channel blockers.

The length of time it takes for Carotid Artery Stenosis to heal varies on the degree of obstruction and the selected course of therapy. In certain situations, making lifestyle adjustments and using medication might help control symptoms and stop future artery damage. However, in more extreme circumstances, it could be required to perform surgical procedures such as carotid endarterectomy or carotid artery stenting. Recovery time for these procedures can vary from a few days to several weeks, and a full recovery may take several months.

The results of surgery for Carotid Artery Stenosis can be long-lasting, but they may not be permanent. Factors such as lifestyle choices and medical conditions can affect the health of the carotid arteries after surgery. It is important to follow your doctor's recommendations for post-surgical care and monitoring to help maintain the benefits of the surgery.

Here are some common medications used to treat Carotid Artery Stenosis:

• Antiplatelet drugs: These drugs help prevent blood clots from forming in the carotid arteries, reducing the risk of stroke. Examples include aspirin, clopidogrel, and ticlopidine.
• Anticoagulants: These drugs also help prevent blood clots, but they work by inhibiting the clotting proteins in the blood. Examples include warfarin and heparin.
• Statins: These drugs help lower cholesterol levels in the blood and reduce the buildup of plaque in the carotid arteries. Examples include atorvastatin, simvastatin, and rosuvastatin.
• Blood pressure medications: These drugs help lower blood pressure, which can reduce the risk of complications associated with Carotid Artery Stenosis. Examples include angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, and calcium channel blockers.

In India, the following are some estimated expenses for treating Carotid Artery Stenosis:

• Carotid endarterectomy: The carotid artery plaque accumulation is removed during this surgical operation. The cost of carotid endarterectomy in India can range from ₹1.5 to 3 lakhs.
• Carotid angioplasty and stenting: This minimally invasive procedure involves widening the narrowed carotid artery using a balloon and placing a stent to keep it open. The cost of carotid angioplasty and stenting in India can range from ₹2 to 4 lakhs.

The following are the adverse effects of Carotid Artery Stenosis medicines that are most often reported:

• Bleeding: At the location of the incision or catheter placement, bleeding might occur.
• Infection: Infection is a possibility where the catheter was inserted or where the incision was made.
• Nerve damage: The nerves in the area around the carotid artery may be damaged during the procedure, leading to temporary or permanent weakness, numbness, or tingling in the face or neck.
• Stroke: In rare cases, Carotid Artery Stenosis treatments may cause a stroke, which can lead to paralysis, difficulty speaking or understanding speech, vision problems, or cognitive impairment.
• Blood clots: Blood clots may form in the treated artery or in other parts of the body, which can increase the risk of stroke or other complications.
• Re-stenosis: In some cases, the carotid artery may become narrowed again after treatment.