They are located in the lateral cervical region, left and right, as branches of the aorta that travel through the neck, heading for the skull and supplying blood to the face and brain. We have the internal carotid artery which supplies blood to the brain and the external carotid artery which supplies blood to the facial anatomy.

The most common and frequently asked questions about carotid artery stenosis and available treatments are answered by Mr. Georgios Eleftheriou Vascular surgeon – Doctor of Medical School of the University of Athens, Director Vascular Surgeon at Metropolitan Hospital & Partner at the HealthSpot Diagnostic Centers of Kifissia:

What is carotid artery stenosis?

Carotid artery stenosis is a condition in which the carotid arteries become narrowed or completely blocked due to a buildup of atherosclerotic plaque in the artery walls. This can reduce blood flow to the brain and increase the risk of stroke. Carotid stenosis is the most common cause of stroke, which is listed as the third leading cause of death in developed countries and the leading cause of physical disability.

What are the most common symptoms of carotid stenosis?

Carotid artery disease in the majority of patients is asymptomatic. However, there are cases with warning signs, such as:

  • Weakness or numbness in the face or limbs
  • Difficulty speaking or understanding speech
  • Blurred vision or sudden loss of vision in one eye
  • Dizziness or loss of balance
  • Severe headache

What causes carotid artery narrowing?

The most common cause of carotid artery narrowing is atherosclerosis, a condition where atherosclerotic plaque builds up in the arteries over time. Other risk factors that may contribute to narrowing of the artery include:

  • High blood pressure
  • High cholesterol
  • Smoking
  • Diabetes
  • Family history of stroke or heart disease

“In patients over 65 years of age who show more than three predisposing factors for atherosclerosis or have severe coronary disease, it is necessary to perform a preventive check for carotid stenosis,” the expert points out.

How is carotid artery stenosis diagnosed?

Carotid stenosis can be diagnosed through a variety of tests, including:

  • Doppler ultrasound: This test uses sound waves to create images of the arteries and determine the degree of narrowing or blockage.
  • Magnetic angiography (MRA): Performed using magnetic fields and radio waves to create detailed images of the arteries.
  • CT angiography (CTA): This test uses X-rays and computer technology to create detailed pictures of the carotid arteries.
  • Intra-arterial digital angiography (IA DSA): It is an invasive method and gives the most detailed picture of the condition of the carotid arteries. Considered the reference exam.

What are the treatments for carotid artery stenosis?

The goal of treatment for carotid artery stenosis is to prevent a stroke from occurring. The main indication for treatment is symptomatic strictures of more than 50% and asymptomatic strictures of more than 70%.
The most common treatments include:

  1. Medicines: Medicines can be used to lower blood pressure and cholesterol levels, reduce the risk of blood clots, and improve blood flow to the brain.
  2. Lifestyle changes: Lifestyle changes, such as stopping smoking, eating a healthy diet and exercising regularly, can help reduce the risk of stroke and improve overall health.
  3. Carotid endarterectomy: This is a surgical procedure that involves removing plaque from the carotid artery to improve blood flow to the brain.
  4. Angioplasty using stents: A minimally invasive procedure that involves placing a stent in the narrowed artery to improve blood flow. It is carried out in patients with severe cardiorespiratory problems, with coexisting lesions in but supra-aortic vessels, those with an immobilized neck, in overweight patients with severe carotid stenosis, but also in cases of restenosis after endarterectomy, in contralateral internal carotid occlusion, but also in stenosis after radiation. The operation lasts an hour and its purpose is to remove the atherosclerotic plaque that causes the narrowing. The risk of overall complications is extremely low, since it is set at only 1% and the hospitalization lasts two days.

“Carotid stenosis is a serious condition that can increase the risk of stroke and other health complications. If you are experiencing any symptoms of carotid artery stenosis or have risk factors for the condition, it is important to seek medical attention immediately,” concludes Mr. Eleftheriou.