Do you also have a blocked carotid artery in your neck? Let's learn everything about it!

Oh, have you ever thought about how serious a problem it can be if the large blood vessels on either side of our neck become blocked? Sometimes this can happen without any symptoms. Today we are going to talk about a disease that can develop slowly and suddenly pave the way for a life-threatening condition like stroke . This is what we call Carotid Artery Stenosis .

What is Carotid Artery Stenosis?

Simply put, Carotid Artery Stenosis is a condition where the Carotid Arteries on either side of your neck, the main blood vessels that carry blood to your brain, face, and head, become blocked from the inside. Think of it like a water pipe getting clogged with dirt and rust, which slows down the flow of water. The main cause of this blockage is a buildup of a substance called plaque inside the arteries. This `plaque` is mainly made up of fatty cholesterol deposits .

We have two carotid arteries on either side of our neck. In a healthy person, these arteries are like a clean pipe, with blood flowing smoothly without any obstruction. This blood is what carries the oxygen and nutrients our brain needs. So, when plaque builds up in one or both of these blood vessels, the amount of blood flowing to the brain decreases. This is what doctors call atherosclerosis . This condition gradually builds up over time, and if left untreated, it can lead to a dangerous stroke , and even death.

How common is this condition?

It is estimated that about 5% of the general population may have this condition. According to the American Stroke Association , stroke is the fifth leading cause of death. The risk of carotid artery occlusion, as well as stroke, increases with age. That is, it is something that gradually increases over time.

What are the causes and risk factors for this?

There are several factors that contribute to carotid artery stenosis. The best part is that we can control some of them. Here are some of them:

• Tobacco and cigarette use: This is a major contributor to many diseases. Smoking damages blood vessels and increases the risk of plaque buildup.
• Obesity: Like other diseases that come with body fat, obesity also affects this.
• Sedentary lifestyle: This risk is higher for someone who works in a chair all day and does not exercise.
• High blood pressure (High blood pressure / Hypertension):When the pressure increases, the walls of the blood vessels can be damaged, making it easier for plaque to build up.
• High cholesterol: If the cholesterol level in the blood is high, the main ingredient for the formation of the `plaque' we mentioned is available.
• Diabetes Mellitus: People with diabetes are also more likely to develop blood vessel problems. Diabetes changes the walls of blood vessels, making it easier for plaque to build up.
• Age: As you get older, your risk for many diseases naturally increases. This is no exception.

When one or more of these factors are combined, the risk of carotid artery occlusion increases even more.

What are the symptoms of this disease?

Often, carotid artery blockages cause no symptoms until a stroke occurs. A stroke occurs when plaque in the artery breaks off, or a blood clot forms on the plaque and travels to the brain, blocking a small blood vessel in the brain. This is also called an ischemic stroke . When blood flow is cut off in this way, brain cells are deprived of oxygen and nutrients and begin to die.

Some people may have a transient ischemic attack (TIA) before a major stroke. This is like a "mini-stroke." This is when a blood vessel in the brain temporarily becomes blocked and then reopens. A TIA is a serious warning sign that a major stroke is coming.

Important: Even if the symptoms of a TIA go away within a few minutes, don't ignore it. Seeking immediate medical attention can help prevent a major stroke.

What are the symptoms of a stroke or TIA?

These symptoms can come on suddenly. If you have any of these , you should go to the hospital immediately :

• One side of the face droops: When asked to smile, one side of the face cannot smile properly.
• Difficulty speaking or slurring words: It is difficult for others to understand what is being said, and words are slurred.
• Loss or blurring of vision in one eye: It may feel like a black curtain is falling in front of one eye.
• Numbness or loss of feeling on one side of the body.
• Muscle weakness and loss of strength on one side of the body: inability to lift an arm or leg, difficulty walking.

You can use the acronym FAST to remember these characteristics:

• F - Face Drooping
• A - Arm Weakness
• S - Speech Difficulty
• T - Time to call emergency services (hospitalize immediately)

Even if there is a blockage in the carotid artery, it can cause paralysis.If you don't have a cold, you may not notice any symptoms. That's why this is a little scary.

How is this disease diagnosed?

Most of the time, carotid artery stenosis is diagnosed after you develop symptoms of a stroke. It's only discovered when doctors are doing tests to find the cause of the stenosis.

Sometimes, when a doctor examines your neck with a stethoscope for another reason, they may hear an unusual sound, a whistling sound (bruit) coming from inside the blood vessels. That can also raise suspicion about this disease.

Doctors use several tests to confirm this disease and determine exactly how much and where the blockage is:

• Ultrasound scan (Ultrasound / Duplex Ultrasound): This uses sound waves to produce images of the blood vessels inside the body. This is a painless, simple test that is performed on the surface of the skin. It can check the way blood flows inside the blood vessels and whether there is any blockage or narrowing.
• CT Angiography (Computed Tomography Angiography - CTA): This test uses a machine called a `CT` scanner (a device that uses X-rays to take detailed pictures of the inside of the body) to take detailed pictures of the carotid arteries. During this test, a special dye is injected into the blood vessels. This dye makes the blocked areas clearly visible in the images. This test can also be done for people who have a `pacemaker` implanted or who have `stents` inserted for other diseases.
• Cerebral Angiography: This is also a diagnostic test. However, in this test, a small catheter (thin tube) is passed through a blood vessel and the blockage is examined. In this test, a similar dye is injected into the blood vessels to see the details of the veins clearly. This is a slightly more complicated test.
• MR Angiography (Magnetic Resonance Angiography - MRA): This is similar to a CT scan, but it does not use X-rays. The images are taken using magnetic fields and radio waves. This can also produce detailed images of the blood vessels. This is also a painless test.

How do you classify this blockage?

When making a diagnosis, doctors look at whether you have the condition, how severe it is, and where it is located. Carotid artery stenosis is generally divided into three main categories: mild, moderate, and severe.

• A mild blockage is one where the blockage is less than 50%, meaning it is less than half full.
• Moderate congestion is between 50% and 79% congestion.
• Severe blockage is between 80% and 99% blockage, meaning a large amount is blocked. This is the most dangerous level.

How is this treated?

The main goal of treating carotid artery stenosis is to stop the disease from getting worse. This starts with lifestyle changes :

• Eating a good healthy diet.(Foods low in oil, salt, and sugar, high in fruits and vegetables)
• Exercising regularly .
• Stop smoking completely.

In addition, doctors may also recommend daily aspirin , a baby dose of blood thinners, blood pressure medications, and cholesterol-lowering medications.

However, if the blockage is severe, or if you are showing symptoms of a TIA or stroke, doctors may recommend surgery.

• Carotid Endarterectomy: This involves making a small incision in the neck, opening the blood vessel, and removing the plaque that has built up inside.
• Stenting: This involves inserting a small mesh-like stent into the blocked blood vessel using a needle-like device, widening the blood vessel from the inside. The plaque then gets trapped between the stent and the blood vessel wall, allowing blood flow to continue without obstruction.

A vascular surgeon or specialist will decide which of these two surgeries is right for you.

Not all carotid artery blockages require surgery or stenting. These treatments also have risks. Doctors recommend these treatments only if the risk of paralysis from the blockage outweighs the risks of surgery.

What happens after these surgeries? How long does it take to recover?

Carotid artery stenosis can be dangerous if not recognized and treated quickly. It can lead to paralysis , death, or permanent disability. Therefore, it is important to be aware of the symptoms of a stroke and take immediate action if you or someone else notices such a sign.

Early treatment of carotid artery stenosis can save lives. When necessary, surgery and stenting have very good results. Most people only stay in the hospital overnight and recover very quickly.

As you age, your risk of developing carotid artery disease increases. The most important thing you can do to prevent this condition, and to prevent complications like stroke, is to maintain a healthy lifestyle . Examples include exercising, eating a healthy diet, and not smoking. See your family doctor and your cardiologist regularly and follow their advice. Talk to your doctor about ways to keep your heart and circulatory system healthy.

Take-Home Message

Okay, so, from what we've talked about, these are the most important things you need to remember:

• Carotid Artery Stenosis is a condition in which the main blood vessel in the neck becomes blocked by fatty deposits (plaque). ThisStroke may occur.
• Smoking, obesity, high blood pressure, high cholesterol, diabetes, and aging are the main risk factors for this.
• Most of the time, this can happen without any symptoms . However, if you have a `TIA` (mini-stroke) or symptoms of a stroke (facial drooping, difficulty speaking, weakness in an arm or leg), go to the hospital immediately .
• This can be detected through tests such as ultrasound, CTA, and MRA .
• Treatment includes lifestyle changes, medications, and, if necessary, surgery (Carotid Endarterectomy) or stent placement .
• The best way to prevent this is to live a healthy lifestyle .

Got it? If you have any more questions about this, don't be afraid to talk to your doctor. Stay healthy!

` Carotid Artery Stenosis, Blockage of the Blood Vessels in the Neck, Paralysis, Stroke, Blood Flow to the Brain, Fat Deposits, High Cholesterol, High Blood Pressure, Smoking, Symptoms, Treatment, Carotid Artery Stenosis Sinhala