Carotid Artery Disease in India
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. This gradual build-up is due to diabetes, high blood cholesterol, tobacco and high blood pressure.
Symptoms of Carotid Artery Disease
Carotid artery disease may not cause signs or symptoms until it severely narrows or blocks a carotid artery. Signs and symptoms may include a bruit, a transient ischemic attack (TIA), or a stroke.
- 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
Causes of Carotid Artery Disease
Carotid artery disease seems to start when damage occurs to the inner layers of the carotid arteries. Major factors that contribute to damage include:
- High levels of certain fats and cholesterol in the blood
- High blood pressure
- High levels of sugar in the blood due to insulin resistance or diabetes
- Diagnosis of Carotid Artery Disease
- The doctor will diagnose carotid artery disease based on your medical history, a physical exam, and test results.
- Medical History
- The doctor will find out whether you have any of the major risk factors for carotid artery disease. He or she also will ask whether you’ve had any signs or symptoms of a mini-stroke or stroke.
- To check your carotid arteries, your doctor will listen to them with a stethoscope. He or she will listen for a whooshing sound called a bruit. This sound may indicate changed or reduced blood flow due to plaque buildup. To find out more, your doctor may recommend tests.
- Diagnostic Tests
- The following tests are common for diagnosing carotid artery disease. If you have symptoms of a mini-stroke or stroke, your doctor may use other tests as well.
Carotid ultrasound (also called sonography) is the most common test for diagnosing carotid artery disease. It’s a painless, harmless test that uses sound waves to create pictures of the insides of your carotid arteries. This test can show whether plaque has narrowed your carotid arteries and how narrow they are.
A standard carotid ultrasound shows the structure of your carotid arteries. A Doppler carotid ultrasound shows how blood moves through your carotid arteries.
- Carotid angiography (an-jee-OG-ra-fee) is a special type of x ray. This test may be used if the ultrasound results are unclear or don’t give your doctor enough information.
- For this test, your doctor will inject a substance (called contrast dye) into a vein, most often in your leg. The dye travels to your carotid arteries and highlights them on x-ray pictures.
- Magnetic Resonance Angiography
- Magnetic resonance angiography (MRA) uses a large magnet and radio waves to take pictures of your carotid arteries. The doctor can see these pictures on a computer screen.
- For this test, The doctor may give you contrast dye to highlight your carotid arteries on the pictures.
- Computed Tomography Angiography
- Computed tomography (to-MOG-rah-fee) angiography, or CT angiography, takes x-ray pictures of the body from many angles. A computer combines the pictures into two- and three-dimensional images.
Treatment for Carotid Artery Disease
Treatments for carotid artery disease may include healthy lifestyle changes, medicines, and medical procedures. The goals of treatment are to stop the disease from getting worse and to prevent a stroke. Your treatment will depend on your symptoms, how severe the disease is, and your age and overall health.
- Heart-Healthy Lifestyle Changes
- The doctor may recommend heart-healthy lifestyle changes if you have carotid artery disease. Heart-healthy lifestyle changes include:
- Heart-healthy eating
- Maintaining a healthy weight
- Managing stress
- Physical activity
- Quitting smoking
If you have a stroke caused by a blood clot, you may be given a clot-dissolving, or clot-busting, medication. Medicines to prevent blood clots are the mainstay treatment for people who have carotid artery disease. They prevent platelets from clumping together and forming blood clots in your carotid arteries, which can lead to a stroke
You may need a medical procedure if you have symptoms caused by the narrowing of the carotid artery. Doctors use one of two methods to open narrowed or blocked carotid arteries: carotid endarterectomy and carotid artery angioplasty and stenting.
- Carotid endarterectomy is mainly for people whose carotid arteries are blocked 50 percent or more.
- For the procedure, a surgeon will make a cut in your neck to reach the narrowed or blocked carotid artery. Next, he or she will make a cut in the blocked part of the artery and remove the artery’s inner lining that is blocking the blood flow.
- Finally, your surgeon will close the artery with stitches and stop any bleeding. He or she will then close the cut in your neck.
Carotid Artery Angioplasty and Stenting
Doctors use a procedure called angioplasty to widen the carotid arteries and restore blood flow to the brain.
A thin tube with a deflated balloon on the end is threaded through a blood vessel in your neck to the narrowed or blocked carotid artery. Once in place, the balloon is inflated to push the plaque outward against the wall of the artery.
A stent (a small mesh tube) is then put in the artery to support the inner artery wall. The stent also helps prevent the artery from becoming narrowed or blocked again.
Cost of Carotid Artery Disease
The cost of carotid artery surgery is substantially lower in India das compared to rest of the world ue to its excellent health care facilities.