Carotid Artery Stenosis: Features, Causes, Symptoms, Treatment, and Surgical Methods

What is Carotid Artery Atherosclerosis?

Carotid artery atherosclerosis is a disease in which atherosclerotic plaques (fat, cholesterol, cellular debris, etc.) accumulate in the carotid arteries (major blood vessels that go to the brain through the neck), narrowing or stiffening the blood vessels. This condition can interfere with blood flow to the brain and is one of the major causes of stroke and other cardiovascular diseases. Carotid artery atherosclerosis is mainly related to lifestyle habits such as hypertension, diabetes, hyperlipidemia, and smoking, and the probability of occurrence increases with age.

Definition of Carotid Artery Atherosclerosis

Carotid artery atherosclerosis refers to a condition in which fats and cholesterol accumulate in the inner walls of the carotid arteries, forming plaques and narrowing or stiffening the blood vessels. In this process, blood flow is obstructed, and in severe cases, blood clots form, blocking blood flow to the brain. If blood supply is cut off, it can lead to serious brain diseases such as stroke. Carotid artery atherosclerosis often has no symptoms in the early stages, but symptoms may gradually appear over time.

Characteristics of Carotid Artery Atherosclerosis

1. Gradual Progression: Carotid artery atherosclerosis generally progresses gradually over time. In the early stages, there may be no symptoms or only mild symptoms.
2. Narrowing of Blood Vessels: Plaque buildup narrows blood vessels, restricting blood flow, and in severe cases, it can completely block blood flow.
3. Hypertension and Hyperlipidemia: Hypertension and hyperlipidemia are major risk factors that worsen carotid artery atherosclerosis.
4. Risk Factors: Carotid artery atherosclerosis is generally associated with factors such as advanced age, smoking, hyperlipidemia, diabetes, and family history.

Causes of Carotid Artery Atherosclerosis

There are various major causes of carotid artery atherosclerosis, and the most important cause is accumulation of fat and cholesterol.

1. Hyperlipidemia (High Cholesterol): Excessive LDL cholesterol (bad cholesterol) and triglycerides accumulate in blood vessels, causing atherosclerosis.
2. Hypertension: Hypertension increases the pressure on blood vessels, damaging the blood vessel walls. Fats and cholesterol accumulate in the damaged blood vessels, causing atherosclerosis to progress.
3. Smoking: Smoking constricts blood vessels, raises blood pressure, and causes inflammation within blood vessels, worsening atherosclerosis.
4. Diabetes: Diabetes promotes inflammation of blood vessels and increases blood lipid levels, worsening atherosclerosis.
5. Genetic Factors: People with a family history are at greater risk of developing carotid artery atherosclerosis.
6. Irregular Diet: High-fat, high-calorie, and high-salt diets can promote the development of atherosclerosis.

Symptoms of Carotid Artery Atherosclerosis

Carotid artery atherosclerosis may have no symptoms or only mild symptoms in the early stages, but various symptoms can appear if the blood vessels become severely narrowed or blocked. The main symptoms are as follows:

1. Transient Ischemic Attack (TIA): If the carotid artery is narrowed, transient ischemic attack (TIA) may occur. TIA is caused by temporary lack of blood flow to the brain, and symptoms disappear within 24 hours. Symptoms include slurred speech, paralysis of arms or legs, visual impairment, and dizziness.
2. Fainting and Dizziness: Lack of blood flow due to carotid artery atherosclerosis can cause dizziness or fainting.
3. Speech Disorders: If the carotid artery is severely narrowed, lack of blood flow to the brain can cause slurred speech or speech disorders.
4. Paralysis and Sensory Disturbances: If blood flow to the brain is insufficient, paralysis or sensory disturbances in the arms and legs may occur.
5. Headache and Visual Impairment: Insufficient blood flow to the brain can cause headaches or visual impairment.

Treatment Methods for Carotid Artery Atherosclerosis

In the early stages, carotid artery atherosclerosis can be managed through medication or lifestyle changes, and surgical treatment may be necessary in severe cases. The treatment methods are as follows:

1. Medication

• Antihypertensive Drugs: If hypertension is the cause, medication to lower blood pressure is needed.
• Statins: Statins help reduce cholesterol levels, reducing plaque buildup.
• Anticoagulants: Anticoagulants can be used to prevent blood clot formation.
• Blood Sugar Control Medications: If diabetes is present, medication to manage blood sugar is needed.

2. Lifestyle Changes

• Healthy Diet: A low-fat, low-salt, high-fiber diet can help prevent and improve atherosclerosis. Meals including fruits, vegetables, and whole grains are especially important.
• Regular Exercise: Regular exercise helps control weight and lower blood pressure and cholesterol levels.
• Smoking Cessation: Smoking worsens atherosclerosis, so smoking cessation is essential.
• Weight Management: If overweight or obese, weight loss can help prevent and treat atherosclerosis.

3. Surgical Treatment

• Carotid Endarterectomy: If the carotid artery is severely narrowed or blocked, surgery can remove the plaque and restore normal blood flow. This surgery is performed when atherosclerosis is very advanced.
• Carotid Artery Stenting: This method involves inserting a stent into the carotid artery to widen the blood vessel. This procedure can be performed minimally invasively using an endoscope.
• Bypass Surgery: If the carotid artery narrowing is severe and other treatments are ineffective, bypass surgery can be used to allow blood to flow through a different pathway.

Prognosis and Management of Carotid Artery Atherosclerosis

With appropriate treatment and management, the prognosis for carotid artery atherosclerosis is relatively good. However, if left untreated or poorly managed, it can lead to serious complications such as stroke. The main management methods are as follows:

1. Regular Checkups: People with risk factors such as hypertension, diabetes, and hyperlipidemia should visit the hospital regularly for checkups. It is important to check blood pressure, cholesterol levels, and blood sugar levels, and to receive early treatment if any abnormalities are found.
2. Cardiovascular Health Management: Maintaining cardiovascular health through regular exercise and a healthy diet is important.
3. Stress Management: Stress raises blood pressure and negatively impacts the cardiovascular system, so stress management is also important.
4. Medication Adherence and Treatment Maintenance: It is important to consistently take medication as prescribed by a doctor and monitor the treatment status through regular checkups.

Conclusion

Carotid artery atherosclerosis is mainly related to hypertension, hyperlipidemia, diabetes, and smoking, and over time, it gradually narrows blood vessels and interferes with blood flow, leading to serious diseases such as stroke. Although symptoms may be absent or mild in the early stages, symptoms can be alleviated and complications can be prevented through appropriate treatment and management. Carotid artery atherosclerosis can be effectively managed through medication, lifestyle changes, and surgical treatment when necessary.