Atherosclerosis is a potentially serious condition where arteries become clogged with fatty substances called plaques, or atheroma. These plaques cause the arteries to harden and narrow, restricting the blood flow and oxygen supply to vital organs, and increasing the risk of blood clots that could potentially block the flow of blood to the heart or brain. Atherosclerosis does not tend to have any symptoms at first and many people may be unaware they have it, but it can eventually cause life-threatening problems, such as heart attacks and strokes, if it gets worse. But the condition is largely preventable with a healthy lifestyle, and treatment can help reduce the risk of serious problems happening. If left to get worse, atherosclerosis can potentially lead to a number of serious conditions known as cardiovascular disease (CVD). There will not usually be any symptoms until CVD develops. Types of CVD include: Exactly why and how arteries become clogged is unclear. It can happen to anyone, although the following things can increase your risk: You cannot do anything about some of these factors, but by tackling things like an unhealthy diet and a lack of exercise you can help reduce your risk of atherosclerosis and CVD. Find out more about the risk factors for CVD Speak to your GP if you're worried you may be at a high risk of atherosclerosis. If you're between the ages of 40 and 74, you should have an NHS Health Check every 5 years, which will include tests to find out if you're at risk of atherosclerosis and CVD. Your GP or practice nurse can work out your level of risk by taking into account factors such as:
Depending on your result, you may be advised to make lifestyle changes, consider taking medication or have further tests to check for atherosclerosis and CVD. Making healthy lifestyle changes can reduce your risk of developing atherosclerosis and may help stop it getting worse. The main ways you can reduce your risk are: Read more specific advice about preventing CVD There are not currently any treatments that can reverse atherosclerosis, but the healthy lifestyle changes suggested above may help stop it getting worse. Sometimes additional treatment to reduce the risk of problems like heart attacks and strokes may also be recommended, such as:
Page last reviewed: 02 May 2019 A stroke is any sudden event affecting the brain’s blood supply. The most common type, almost 80% of all strokes, is ischemic stroke, where the blood supply to the brain is cut off or severely reduced due to a blocked artery. A condition known as stenosis contributes to an individual’s risk for this type of stroke. Stenosis, in general, refers to any condition in which a blood vessel -- such as an artery -- or other tubular organ becomes abnormally narrow. In the context of stroke, “stenosis” is usually caused by atherosclerosis, a condition where a blood vessel supplying blood to the brain is narrowed due to fatty deposits, known as plaques, on the vessel’s inside wall. Risk factors for this type of stenosis include high blood pressure and high cholesterol. How does stenosis contribute to stroke? Atherosclerosis can activate cells involved in blood clotting. As clots form, they can obstruct narrowed blood vessels in the neck (the carotid artery) or the small blood vessels of the brain (intracranial arteries). Additionally, a clot or piece of the plaque can break free and flow to the brain and block an artery. How is stenosis treated? Several factors influence how stenosis can be treated, including the percentage of blood vessel blockage and the patient’s overall risk of a first or second stroke. Another especially important factor is the location of the stenosis, as treatment of stenosis inside the small, twisting arteries that reach deep inside the brain presents a more difficult challenge than treatment of stenosis in the large, carotid arteries in the neck. NINDS supports many clinical trials to examine the best practices for preventing and treating stroke. Medication and lifestyle changes can be used to manage stenosis. In some cases surgery is recommended. Surgical procedures include:
Carotid endarterectomy is an option for treatment when stenosis occurs in one or both of the carotid arteries, the large arteries in the neck that supply blood to the brain. Two large clinical trials evaluated the efficacy of carotid endarterectomy: the North American Symptomatic Carotid Endarterectomy Trial (NASCET) and the Asymptomatic Carotid Atherosclerosis Study (ACAS). NASCET evaluated the risks and benefits of carotid endarterectomy for individuals who experienced a stroke or other symptoms due to the stenosis such as a mini stroke or transient ischemic attack (TIA). When performed by a qualified and experienced surgeon, carotid endarterectomy is a very effective stroke prevention therapy for patients with carotid stenosis-related symptoms and greater than 70 percent stenosis in the carotid arteries. ACAS evaluated indivduals with asymptomatic stenosis, where a patient had no symptoms but the arterial blockage was identified in a medical exam. These individuals have a low annual risk of stroke, about 2 to 3 percent per year, and carotid endarterectomy cut this risk in half. In follow-up studies of otherwise healthy individuals five years post-surgery, the decreased annual stroke risk outweighed the risks of the carotid endarterectomy. Another surgical procedure used to treat stenosis in the carotid arteries is stenting. A stent is a device, commonly made of mesh-like material, which is placed into a neck or brain blood vessel using a long, thin catheter tube threaded in through another part of the body, such as the leg. Stents support the narrowed blood vessel and hold it open to enable blood flow to the brain. The Carotid Revascularization Endarterectomy vs. Stenting Trial (CREST) compared the efficacy of carotid endarterectomy to carotid artery stenting and found that these two surgical procedures are effective in preventing future strokes. For more details about this trial, visit the CREST Fact Sheet. Another NINDS-supported study addressed the use of stents to treat stenosis in the arteries inside the brain. Researchers examined patients who were at high risk for a second stroke, and assessed whether the placement of an intracranial stent provided an additional benefit to an aggressive medical regimen that included blood-thinning medications and lifestyle modifications. The study, Stenting vs. Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) showed that, in these high risk patients, the group who participated in the medical regimen alone had better outcomes than those receiving brain stents. Additional resources: For more information about stroke, visit the Know Stroke website at http://www.stroke.nih.gov. NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient's medical history. All NINDS-prepared information is in the public domain and may be freely copied. Credit to the NINDS or the NIH is appreciated. Last Modified March 29, 2016
Carotid artery stenosis is a narrowing of the large arteries on either side of the neck. These arteries carry blood to the head, face, and brain. This narrowing is usually the result of a build-up of plaque within the arteries, a condition called atherosclerosis. Stenosis can worsen over time to completely block the artery which may lead to stroke. Your doctor may use carotid ultrasound, CT angiography (CTA), magnetic resonance angiography (MRA), or cerebral angiography to determine the presence, location, and severity of stenosis. Treatment to improve or restore blood flow may include angioplasty and vascular stenting or, in severe cases, surgery.
Carotid artery stenosis is a narrowing in the large arteries located on each side of the neck. These arteries carry blood to the head, face, and brain. The narrowing usually results from atherosclerosis, or a build-up of plaque on the inside of the arteries. Over time, stenosis can advance to complete blockage of the artery. Risk factors for carotid artery stenosis include age, smoking, high blood pressure, diabetes, obesity, and an inactive lifestyle. Some people with carotid artery stenosis may experience dizziness, fainting, and blurred vision. These may be signs that the brain is not receiving enough blood. In many cases, the first symptom is a stroke or transient ischemic attack (TIA). A small blood clot can form in the artery narrowed by atherosclerosis. The clot can become dislodged and travel into the brain. Once there, it can plug up a smaller artery that the brain depends on to function and survive. Symptoms of a TIA and stroke are similar: paralysis or numbness on one side of the body, blurred vision, headache, trouble speaking, and difficulty responding to others. A TIA is usually brief and leaves no lasting damage. It is due to a temporary occlusion of a small artery. This is often a warning sign. A stroke is often associated with permanent injury of a part of the brain due to loss of blood supply. This can result in mild-severe disability or death. top of page
Carotid artery stenosis sometimes causes an abnormal sound, or bruit, in the artery that your doctor can hear with a stethoscope. Imaging tests to diagnose, localize and measure stenosis include:
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If blockage is mild to moderate, lifestyle modification and certain medications may be recommended to slow the progression of atherosclerosis:
If blockage is severe, surgical treatment may be recommended:
top of page This page was reviewed on June, 15, 2020 |
What does narrowing of the arteries mean?
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