Milmedika

How common is carotid artery disease, and what causes it?

Carotid artery disease becomes more common with age, especially in people with certain risk factors like high cholesterol, smoking, or high blood pressure. Globally, it’s the fifth leading cause of death, making it a significant health concern.

How is carotid artery disease diagnosed?

Duplex ultrasound: The first step in diagnosis

The first step in diagnosing carotid artery narrowing (stenosis) is usually a carotid ultrasound (duplex ultrasonography). This non-invasive test uses sound waves to create a two-dimensional image of the arteries while measuring blood flow. The speed of blood flow is a key indicator of narrowing, even though the test doesn’t directly measure the artery’s size.

Carotid ultrasound is reliable, precise, and widely available, making it an excellent screening method for patients at moderate risk of carotid artery disease.

Additional diagnostic methods

If the ultrasound results are unclear or don’t show significant narrowing in symptomatic patients, additional tests may be recommended, including:

• MRA (Magnetic Resonance Angiography): Creates detailed images of blood vessels, including both the closest and farthest segments of the carotid arteries.
• MSCT (Multi-Slice Computed Tomography): Visualizes sections of the arteries that ultrasound cannot reach, such as those inside the chest.

For high-risk patients, MRA and MSCT are often used as primary diagnostic tools.

In cases where MRA is not suitable—for example, patients with pacemakers—CTA (Computed Tomographic Angiography) is typically recommended. On the other hand, MRA is often the preferred method in patients with vascular calcifications (hardening of the arteries).

For asymptomatic patients being considered for procedures like carotid revascularization, it’s important to confirm ultrasound findings with another test, such as CTA, MRA, or conventional arteriography.

Symptoms of carotid artery disease

These are common signs or reasons to evaluate your carotid arteries:

• A whooshing sound (bruit) over the carotid arteries.
• Monitoring previously diagnosed narrowing in patients without symptoms.
• Risk factors for artery disease, such as high cholesterol, smoking, or high blood pressure.
• Temporary symptoms like weakness, dizziness, or vision loss (known as transient ischemic attacks or amaurosis fugax).
• Carotid arteries inflammation (arteritis).
• Neck injury or trauma.
• Pulsating lumps or noticeable swelling in the neck.
• Stroke in patients being evaluated for carotid revascularization.
• Follow-up care after carotid revascularization procedures.