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Carotid Artery Disease

Carotid artery disease is a disease in which a waxy substance called plaque builds up inside the carotid arteries.

PubMed Health Glossary
(Source: NIH - National Heart, Lung, and Blood Institute)

Carotid Artery Disease

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. They each divide into internal and external carotid arteries.

The internal carotid arteries supply oxygen-rich blood to your brain. 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....Read more about Carotid Artery Disease
NIH - National Heart, Lung, and Blood Institute

What works? Research summarized

Evidence reviews

Extracranial‐intracranial arterial bypass surgery for occlusive carotid artery disease

Patients with symptomatic occlusion (obstruction) of the carotid artery have a high risk of subsequent stroke. Anticoagulant treatment and antiplatelet agents are not very effective in these patients and a surgical procedure known as extracranial‐intracranial (EC/IC) arterial bypass surgery has been a treatment option. In this review, we included 21 trials (two randomised controlled trials and 19 non‐random studies, with a total of 2591 patients). We found that EC/IC bypass surgery in patients with symptomatic carotid artery occlusive disease was no better or worse than medical care alone. A multi‐centre trial comparing EC/IC bypass surgery with best medical treatment in patients with both a high risk of stroke and haemodynamic compromise (impaired blood flow) is underway, and aims to discover whether EC/IC bypass surgery is beneficial in this specific group of patients.

Screening for Asymptomatic Carotid Artery Stenosis: A Systematic Review and Meta-Analysis for the U.S. Preventive Services Task Force [Internet]

To evaluate the evidence on screening and treating asymptomatic adults for carotid artery stenosis (CAS) for the U.S. Preventive Services Task Force (USPSTF).

Carotid endarterectomy for carotid stenosis in patients selected for coronary artery bypass graft surgery

People who have coronary artery disease requiring coronary artery bypass graft (CABG) surgery often have narrowing of other arteries. If the carotid artery, the artery carrying blood to the brain, is narrow (called carotid stenosis), this may increase the risk of stroke and other brain damage, complicating CABG surgery. Surgery to remove the carotid narrowing might prevent these complications of CABG surgery, but also has risks. We found no reliable evidence from randomised trials to indicate whether or not to perform preventive carotid surgery in patients who are going to have CABG surgery.

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Summaries for consumers

Extracranial‐intracranial arterial bypass surgery for occlusive carotid artery disease

Patients with symptomatic occlusion (obstruction) of the carotid artery have a high risk of subsequent stroke. Anticoagulant treatment and antiplatelet agents are not very effective in these patients and a surgical procedure known as extracranial‐intracranial (EC/IC) arterial bypass surgery has been a treatment option. In this review, we included 21 trials (two randomised controlled trials and 19 non‐random studies, with a total of 2591 patients). We found that EC/IC bypass surgery in patients with symptomatic carotid artery occlusive disease was no better or worse than medical care alone. A multi‐centre trial comparing EC/IC bypass surgery with best medical treatment in patients with both a high risk of stroke and haemodynamic compromise (impaired blood flow) is underway, and aims to discover whether EC/IC bypass surgery is beneficial in this specific group of patients.

Carotid endarterectomy for carotid stenosis in patients selected for coronary artery bypass graft surgery

People who have coronary artery disease requiring coronary artery bypass graft (CABG) surgery often have narrowing of other arteries. If the carotid artery, the artery carrying blood to the brain, is narrow (called carotid stenosis), this may increase the risk of stroke and other brain damage, complicating CABG surgery. Surgery to remove the carotid narrowing might prevent these complications of CABG surgery, but also has risks. We found no reliable evidence from randomised trials to indicate whether or not to perform preventive carotid surgery in patients who are going to have CABG surgery.

Drugs and pacemakers for transient loss of consciousness

Neurally mediated reflex syncope (including fainting) is the most common cause of transient loss of consciousness. It is caused by a sudden decrease in blood pressure and/or lowering of heart rate. The main treatment goal therefore is to increase blood pressure and heart rate. In most patients, this can be achieved by non‐pharmacological treatment measures (e.g. adequate fluid and salt intake, physical counterpressure manoeuvres). In patients not responding to this treatment, pharmacological or pacemaker treatment might be considered. We investigated the effectiveness of these treatments for different subtypes of neurally mediated reflex syncope, namely vasovagal syncope (fainting), carotid sinus syncope (fainting due to pressure on the neck) and situational syncope (fainting when passing urine of faeces or swallowing). Where data were available, we determined the treatment effectiveness for different outcome measures including occurrence of syncope, amount of (pre‐)syncopes per year during follow‐up and quality of life.

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Terms to know

Arteries
A blood vessel that carries blood from the heart to tissues and organs in the body.
Carotid Arteries
Major arteries that carry blood from the heart to the head. There is a carotid artery on each side of the neck, and each one splits into two branches. The interior branch carries blood to the brain and eyes, and the exterior branch carries blood to the face, tongue, and outside parts of the head.
Oxygenated Blood
Oxygen-rich blood.
Plaque
In medicine, a small, abnormal patch of tissue on a body part or an organ. Plaques may also be a build-up of substances from a fluid, such as cholesterol in the blood vessels.

More about Carotid Artery Disease

Photo of an adult

Also called: Disease of carotid artery, Disorder of carotid artery

See Also: Atherosclerosis, Stroke, Aneurysm

Other terms to know: See all 4
Arteries, Carotid Arteries, Oxygenated Blood

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