Carotid Artery Disease

What Is Carotid Artery Disease?

Carotid artery disease occurs when the carotid arteries, the two major blood vessels in the neck that deliver oxygen‑rich blood to the brain, become narrowed or blocked. This narrowing is usually caused by atherosclerosis, the buildup of fatty deposits (plaque) on the artery walls. As plaque accumulates, blood flow to the brain can be restricted, increasing the risk of transient ischemic attack (TIA) or stroke.

Because the brain relies on a continuous blood supply, even brief blockages can cause serious neurological symptoms or permanent disability. Carotid artery disease often develops over many years and may not produce obvious symptoms until blood flow is significantly impaired.

Causes and Risk Factors

The most common underlying cause of carotid artery disease is atherosclerosis. Factors that increase the risk of plaque buildup and carotid narrowing include:

  • Smoking
  • High blood pressure (hypertension)
  • High cholesterol
  • Diabetes
  • Age (risk increases with advancing age)
  • Family history of vascular disease
  • Sedentary lifestyle or obesity

These risk factors contribute to inflammation and plaque formation in arteries throughout the body. When this occurs in the carotid arteries, the risk of stroke and TIA rises.

Signs and Symptoms

Carotid artery disease may not cause symptoms until blood flow is significantly compromised or a small piece of plaque breaks off and travels to the brain. Common signs include:

  • Sudden numbness or weakness, especially on one side of the body
  • Difficulty speaking or slurred speech
  • Sudden vision changes in one or both eyes
  • Dizziness or loss of balance
  • Sudden, severe headache

These symptoms can be warning signs of TIA or stroke and require immediate medical attention.

Diagnosis and Evaluation

Carotid artery disease is typically diagnosed through a combination of clinical assessment and imaging tests. Common diagnostic tools include:

  • Carotid ultrasound — a non‑invasive test that visualizes blood flow and plaque in the carotid arteries
  • CT angiography or MR angiography — advanced images that help define plaque location and degree of narrowing
  • Physical exam — listening for a bruit (abnormal sound) over the carotid artery

These studies help physicians determine the severity of narrowing and guide treatment planning.

Treatment Options

Treatment for carotid artery disease depends on the degree of narrowing, presence of symptoms, and overall health. Options may include:

  • Medical management — involves medications and lifestyle changes to control blood pressure, cholesterol, and other risk factors
  • Carotid endarterectomy — a surgical procedure to remove plaque from the artery and restore normal blood flow
  • Carotid artery stenting — a minimally invasive procedure in which a small mesh tube (stent) is placed inside the artery to keep it open

Symptomatic disease (TIA or minor stroke) or severe narrowing (typically ≥70% blockage) is often treated with surgical or endovascular intervention to reduce stroke risk.

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Frequently Asked Questions

Carotid artery disease is primarily caused by atherosclerosis — the buildup of fatty plaque in the artery walls that narrows the vessel and restricts blood flow.

Sudden weakness, numbness on one side of the body, difficulty speaking, vision changes, or dizziness can be signs of TIA or stroke and require urgent medical evaluation.

It is diagnosed with imaging studies such as carotid ultrasound, CT angiography, or MR angiography, which show the degree of narrowing and plaque buildup.

Treatment includes risk factor management (medications and lifestyle changes), carotid endarterectomy, or carotid artery stenting, depending on severity and symptoms.

Not always. Mild, asymptomatic narrowing may be managed with medication and lifestyle changes. Surgery or stenting is usually recommended for severe narrowing or symptoms.

Controlling high blood pressure, quitting smoking, maintaining healthy cholesterol and blood sugar levels, regular exercise, and a balanced diet can reduce the risk of carotid artery disease.