What is the carotid artery?
The right common carotid artery extends up the neck off the innominate artery which is the first major branch off the aorta – the main artery in the body. The left common carotid artery is the second main branch and arises directly off the aorta.
The left and right carotid arteries carry blood and oxygen to the brain and head and face. A clot or blockage in the carotid can cause serious complications.
What are the parts of the carotid artery?
Each carotid artery in the neck divides into two branches. These branches are the internal carotid artery and the external carotid artery. The internal carotid artery supplies the brain. The external carotid artery divides into seven branches which supply the head, face and neck.
All arteries, including the carotid arteries, have three layers:
- Intima, a smooth innermost layer to allow blood to flow easily.
- Media, a muscular middle layer that helps control the diameter of the artery.
- Adventitia, the protective outer layer of the artery.
Common Conditions & Disorders
What causes problems with the carotid arteries?
The most common problems related to the carotid arteries are narrowing or blockages. The most common type of blockages are due to buildup of plaque or atherosclerosis. Narrowing in the carotid artery can also occur due to dissections, which are tears in the lining of the blood vessel. The carotid artery can also enlarge and form aneurysms.
Without adequate blood flow, the brain doesn’t get enough oxygen or nutrients. The condition can cause problems with how your brain and body function. In severe cases, carotid artery problems are life-threatening.
What are common carotid artery disorders?
Problems related to the carotid arteries include:
- Carotid artery disease: This condition is also called carotid artery stenosis. Stenosis means “narrowing.” Narrowed carotid arteries most often occur because of atherosclerosis, an accumulation of plaque along artery walls. The plaque that blocks or narrows the arteries is the result of a buildup of cholesterol deposits. In some cases, a plaque can rupture or break off leading to pieces of those blockages travelling to the brain and blocking the brain arteries leading to a stroke. Debris or platelets and clot can also form on the atherosclerotic plaque which can break off and block the brain arteries and lead to stroke.
- Stroke: The most serious outcome of carotid artery disease is stroke. An ischemic stroke results from blockage of a brain artery leading lack of oxygen to the brain and death of parts of the brain.
- Carotid artery aneurysm: If the wall of the carotid artery is weak, an aneurysm can form. With an aneurysm, the artery expands like a balloon. If the aneurysm grows large enough, it can rupture (burst) or have clot that builds up break off and go to the brain and cause strokes.
- Fibromuscular dyplasia: This a disorder of the development of the layers of the blood vessel. It can lead to narrowing and dissections of the artery and aneurysm of the artery.
- Dissection: This a tear in the lining of the blood vessel. It can lead to compression of the flow channel in the artery and reduction of flow. The process can lead to complete blockage of the artery or even aneurysm development. Dissections can occur from trauma with whip lash mechanisms or be associated with Fibromuscular dysplasia or aortic dissections.
How are carotid artery conditions diagnosed?
For most people, carotid disease does not cause symptoms. It can be found by examination done by your physician or health care provider. Your healthcare provider will listen to your neck with a stethoscope. A whooshing sound, called a bruit (pronounced BREW-ee), can be heard which is caused by the disturbed blood flow from the narrowing in the carotid artery. Healthcare providers are trained to listen for this whooshing sound in the neck.
For many people, the first sign of carotid artery disease is a transient ischemic attack (also called a TIA or mini-stroke) or a stroke. Anyone who experiences stroke-like symptoms needs immediate medical attention. Call 911 or get to the nearest emergency room as soon as possible.
To diagnose carotid artery disease or aneurysm, your provider may also suggest imaging tests such as:
- Carotid ultrasound.
- CT scan.
- Carotid angiogram.
- Magnetic resonance angiogram (like an MRI of your arteries).
How are carotid artery conditions treated?
Medicines and surgical procedures can treat narrowed or blocked carotid arteries. If you have a carotid artery blockage, your healthcare provider may recommend:
- Antiplatelet medications.
- Blood pressure medications.
- Cholesterol medications.
- Carotid endarterectomy, surgery to remove plaque and clean out the artery to restore blood flow.
- Carotid artery stenting, a minimally invasive procedure to place a stent to compress the plaque and open up your carotid artery.
Caring for Your Carotid Arteries
How can I keep my carotid arteries healthy?
To keep your carotid arteries healthy, you may need to reduce your cholesterol levels. Your provider may prescribe medication to help lower your cholesterol.
You should also follow heart-healthy diet, exercise and lifestyle recommendations. Aim to:
- Eat a diet rich in fruits, vegetables, monounsaturated and polyunsaturated fats and lean sources of protein. You should limit your consumption of saturated and trans fats, red meat, added sugars and sodium.
- Get at least 30 minutes of exercise (like walking) most days.
- Maintain a healthy weight.
- Quit smoking.
When should I call my healthcare provider about carotid artery problems?
Many people don’t know they have any problems with their carotid arteries until they have a TIA or stroke.
Call 911 or go to the nearest emergency room if you experience any of these signs of stroke:
- Inability to speak.
- Slurred speech.
- Weakness of paralysis of one or both sides of the body.
- Loss of feeling in one side or both sides of the body.
- Sudden vision loss in one or both eyes.
- Paralysis of one side of the face.
- Loss of consciousness.
What should I ask my doctor about my carotid arteries?
You may want to ask your healthcare provider:
- Do I have any risk factors that increase my chance of carotid artery disease?
- What lifestyle changes can I make to help keep my carotid arteries healthy?
- Do I need imaging tests to check the condition of my carotid arteries?
- If I have blockages in my carotid arteries, what treatments should I consider?
A note from Cleveland Clinic
There are two carotid arteries, one on either side of the neck. Healthy carotid arteries transport blood and oxygen to the brain and head. If the carotid arteries are narrowed or blocked, not enough blood and oxygen pass through. You can take steps to reduce your cholesterol levels — such as regular exercise and a healthy diet. Prevention can help keep your carotid arteries working as they should. If you do require treatment for carotid artery disease, medications and surgery work very well for most people.
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