Carotid arteries are the major vessels running from your heart to the brain and are responsible for up to a third of all strokes, “They are one of the most common causes of a stroke because these arteries can fill with plaque,” Explained Dr. Emily Malgor, a vascular surgeon at CU Medicine Vascular Surgery - Highlands Ranch.

We talked with her about risk factors, symptoms, and prevention of carotid artery disease.

Carotid Artery Disease Risk Factors

Factors that increase your risk of carotid artery disease include:

• High blood pressure. Excess pressure on artery walls can weaken them and make them more vulnerable to damage.
• High cholesterol/blood-fat levels. High levels of low-density lipoprotein cholesterol and high levels of triglycerides, a blood fat, encourage the accumulation of plaques.
• Renal/Kidney Disease
• Smoking/Tobacco use. Nicotine can irritate the inner lining of your arteries. Smoking also increases your heart rate and blood pressure.
• Diabetes. Diabetes lowers your ability to process fats efficiently, placing you at greater risk of high blood pressure and atherosclerosis.
• Family history. Your risk of carotid artery disease is higher if a relative has atherosclerosis or coronary artery disease.

Talk to your doctor if you have risk factors for carotid artery disease. Even if you don't have any signs or symptoms, your doctor may recommend management of your risk factors to protect you from stroke.

Seeing a doctor early increases your chances that carotid artery disease will be found and treated before a stroke occurs.

Symptoms of Carotid Artery Disease

“Sometimes it’s silent,” said Malgor.

In its early stages, carotid artery disease often doesn’t produce any signs or symptoms. It may go unnoticed until it’s serious enough to cause a stroke, which is why it’s important to have regular checkups with your primary care provider.

Signs and symptoms of a stroke or “mini stroke”/transient ischemic attack (TIA):

• Sudden numbness or weakness on one side of the body in an arm or leg
• Sudden trouble speaking and understanding
• Sudden trouble seeing
• Sudden dizziness or loss of balance
• Sudden severe headache with no known cause

Seek emergency care if you experience any signs or symptoms of stroke. Even if they last only a short while and then you feel normal, see a doctor right away.

Carotid Artery Surgery

Severe carotid artery disease can be treated with surgery or stenting and the process has changed over the last 15-20 years, “Traditionally involves us opening the skin and exposing the vessel. To put it simply we open the artery, clean it out, and closed it.” explained Malgor.

Both open carotid surgery and stent placement using minimally invasive methods are available to patients and involve some risk.

Currently however, transcarotid artery revascularization (TCAR) is the first-line therapy for carotid artery surgery at CU Medicine Vascular Surgery and is kind of a combination of the other two methods.

The procedure involves temporarily reversing blood flow so dislodged plaque pieces travel away from the brain. A stent is then placed in the artery to stabilize plaque and minimize the likelihood of a future stroke.

Compared to other methods for treating carotid artery disease, TCAR provides, “Less likelihood of nerve injury or artery injury,” said Malgor.

Reduce Your Risk of Arterial Disease

“When someone finds out they’re at risk of having a stroke they want to do something and take a more proactive approach,” said Malgor.

While it’s not easy to do, Malgor said one of the best things you can do to reduce your risk is quit smoking. In addition to that, lifestyle changes to lower your blood pressure, cholesterol, and diabetes risk will reduce your risk of carotid artery disease and stroke.

Prevent or slow the progression of carotid artery disease:

• Don't smoke/quit smoking. 
• Maintain a healthy weight. Being overweight contributes to other risk factors
• Limit cholesterol and fat. Cutting back on saturated fat may help reduce the buildup of plaque
• Limit salt. Excess salt (sodium) may increase blood pressure in people who are sensitive to sodium.
• Exercise regularly. Exercise can lower your blood pressure, increase your level of high density lipoprotein (HDL) cholesterol — the "good" cholesterol — and improve the overall health of your blood vessels and heart. It also helps you lose weight, control diabetes and reduce stress.
• Limit alcohol.
• Control chronic conditions such as diabetes and high blood pressure.

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