Carotid artery stenting is a procedure in which a vascular surgeon inserts a slender, metal-mesh tube, called a stent, which expands inside your carotid artery to increase blood flow in areas blocked by plaque. Carotid artery disease is a disease in which a waxy substance called plaque builds up inside the carotid arteries. You have two common carotid arteries, one on each side of your neck, that each divide into internal and external carotid arteries. The internal carotid arteries supply oxygen-rich blood to your brain, while the external carotid arteries supply oxygen-rich blood to your face, scalp, and neck.

Carotid artery disease is serious because it can cause a stroke, also called a “brain attack.” A stroke occurs if blood flow to your brain is cut off. If blood flow is cut off for more than a few minutes, the cells in your brain start to die. This impairs the parts of the body that the brain cells control. A stroke can cause lasting brain damage; long-term disability, such as vision or speech problems or paralysis (an inability to move); or death.

Overview

Over time, plaque hardens and narrows the arteries. This may limit the flow of oxygen-rich blood to your organs and other parts of your body. Atherosclerosis can affect any artery in the body. For example, if plaque builds up in the coronary (heart) arteries, a heart attackcan occur. If plaque builds up in the carotid arteries, a stroke can occur. A stroke also can occur if blood clots form in the carotid arteries. This can happen if the plaque in an artery cracks or ruptures. Blood cell fragments called platelets (PLATE-lets) stick to the site of the injury and may clump together to form blood clots. Blood clots can partly or fully block a carotid artery. A piece of plaque or a blood clot also can break away from the wall of the carotid artery. The plaque or clot can travel through the bloodstream and get stuck in one of the brain's smaller arteries. This can block blood flow in the artery and cause a stroke. Carotid artery disease may not cause signs or symptoms until the carotid arteries are severely narrowed or blocked. For some people, a stroke is the first sign of the disease.

Transient Ischemic Attack (Mini-Stroke)

For some people, having a transient ischemic attack (TIA), or “mini-stroke,” is the first sign of carotid artery disease. During a mini-stroke, you may have some or all of the symptoms of a stroke. However, the symptoms usually go away on their own within 24 hours.

Stroke and mini-stroke symptoms may include:

• A sudden, severe headache with no known cause
• Dizziness or loss of balance
• Inability to move one or more of your limbs
• Sudden trouble seeing in one or both eyes
• Sudden weakness or numbness in the face or limbs, often on just one side of the body
• Trouble speaking or understanding speech

Do not drive yourself to the hospital. It’s important to get checked and to get treatment started as soon as possible.

A mini-stroke is a warning sign that you’re at high risk of having a stroke. You shouldn’t ignore these symptoms. Getting medical care can help find possible causes of a mini-stroke and help you manage risk factors. These actions might prevent a future stroke. Although a mini-stroke may warn of a stroke, it doesn’t predict when a stroke will happen. A stroke may occur days, weeks, or even months after a mini-stroke.

Stroke

The symptoms of a stroke are the same as those of a mini-stroke, but the results are not. A stroke can cause lasting brain damage; long-term disability, such as vision or speech problems or paralysis (an inability to move); or death. Most people who have strokes have not previously had warning mini-strokes. Getting treatment for a stroke right away is very important. You have the best chance for full recovery if treatment to open a blocked artery is given within 4 hours of symptom onset. The sooner treatment occurs, the better your chances of recovery.

How Is Carotid Artery Disease Diagnosed?