Carotid Artery Disease/Transient Ischaemic Attacks (TIA) and Strokes (CVA)

Carotid Artery Disease (CAD) occurs when major arteries in the neck (carotid arteries) that supply blood to the brain become narrowed or blocked. This is caused by a build up of plaque, which causes the arteries to narrow and stiffen. This process is called atherosclerosis.

CAD is most commonly associated with ageing, and is usually found in patients aged 70 years and above. If a piece of plaque breaks off and travels through the arteries, it can lodge in a smaller artery in the brain and cause a stroke.

Warning symptoms of a stroke are called Transient Ischaemic Attacks (TIAs) with symptoms lasting from several minutes to less than 24 hours.

These symptoms can include:

  • Feelings of weakness, numbness or a tingling sensation on one side of the body (i.e. a leg, arm or face)
  • Being unable to control the movement of an arm or leg
  • Loss of vision in one eye (Amaurosis Fugax)
  • Being unable to speak clearly

TIAs should not be ignored as they indicate a serious risk of a stroke.

 It is thought that carotid disease can be prevented or delayed through the following lifestyle choices:

  • Quitting smoking
  • Regular exercise
  • Eating a healthy diet
  • Maintaining a healthy weight
  • Controlling high blood pressure
  • Lowering high cholesterol levels
  • Managing Diabetes well

Diagnostic techniques:

  • Carotid duplex ultrasound
  • Magnetic Resonance Angiography (MRA)
  • Computed Tomography (CT)
  • Computed Tomography Angiography (CTA)
  • Diagnostic Angiography

Treatment options:

  • Medications and lifestyle changes.
  • Carotid Endarterectomy and Patch Angioplasty – an open procedure that involves making an incision into the artery at the location of the carotid plaque, removing the plaque and repairing the artery with a ‘patch’ to widen the vessel.
  • Carotid Angioplasty and Stenting (CAS) – an access is gained to the groin artery (Femoral Artery) using ultrasound guidance and a thin tube called a catheter is guided through the blood vessels to the location of the carotid plaque. A small umbrella-like device (Embolic Protection Device) is inserted beyond diseased parted of carotid artery to stop small particles flowing into the brain during the procedure. The plaque is then flattened and a stent inserted to hold the artery open. The embolic protection device is removed.