Carotid artery stenosis is the narrowing of the carotids, the main arteries in the neck that supply blood to the brain. Their inner diameter is reduced by the presence of plaque. Plaque forms through the deposition of cholesterol and other substances. This process is called atherosclerosis. The plaque is a dynamic element as it may thicken, ulcerate, send small pieces of clot to distal vessels, and ultimately completely occlude the vessel.

Symptoms include:

     •   Transient blindness in one eye

     •   Transient numbness/tingling or weakness of face, arm or leg

     •   Difficulty speaking or understanding others

     •   Confusion, sudden

     •   Severe headache

Treatment depends on numerous factors including the presence or absence of symptoms, the degree of stenosis and the patient’s overall condition.

Medical treatment may be sufficient is some asymptomatic patients or those with small stenosis. Surgery has proven to benefit some particular patient populations notably those with arteries narrowed by 70 percent or more. Carotid endarterectomy consists of removing the plaque responsible for the stenosis.

Endovascular techniques have also been developped to treat carotid artery disease. Carotid dilatation with balloons (angioplasty) and/or stenting may be performed to open the narrowed carotid.

Addressing the causative factors is essential in the management of carotid artery disease. High blood pressure and diabetes must be well controlled. Patients should be encouraged to stop smoking, exercise regularly, and eat a healthy diet.