The Link Between the Risk of Stroke and Carotid Artery Blockage
Stroke is a serious condition that can leave permanent consequences, and carotid artery disease is at the top of its preventable causes. In this article I will explain how a problem in the carotid artery reaches the brain and what this connection is.
How Does a Clot Travel From the Carotid Artery to the Brain?
The plaque that builds up in the carotid artery can crack on its surface over time; blood cells rapidly stick to this cracked surface and form a clot. If a piece of this clot breaks off, it travels with the blood flow directly to the vessels leading to the brain and blocks a small vessel there, suddenly cutting off the blood flow to that area; this event is called a stroke.
What Is a Transient Ischaemic Attack (TIA)?
In some of our patients this blockage lasts a very short time and resolves by itself without permanent damage to the brain tissue; we call this a transient ischaemic attack (TIA or “mini stroke”). A TIA can present as sudden weakness, speech disturbance or loss of vision lasting a few minutes and, even though it passes on its own, it is a serious warning sign of a true stroke.
Does Carotid Artery Surgery Prevent Stroke?
In patients with severe carotid artery narrowing, especially those who have previously had a TIA or a stroke, treating the narrowing with carotid endarterectomy or stenting greatly reduces the risk of future stroke; large randomised trials have clearly shown this benefit. For this reason, in patients who have had a TIA we recommend carotid assessment and, if necessary, treatment as soon as possible (within the first 2 weeks).
Frequently Asked Questions
I had a TIA but my symptoms have gone; does it matter? Yes, it matters a great deal; a TIA is a serious herald of the risk of a true stroke in the near future and requires urgent assessment.
Does everyone with carotid artery narrowing develop a stroke? No; the risk varies according to the degree of narrowing, the structure of the plaque and whether it causes symptoms.
Is carotid artery surgery still beneficial after having a stroke? Yes, once the acute period has been overcome, treatment performed with appropriate timing is valuable in reducing the risk of a recurrent stroke.
Conclusion
A problem in the carotid artery increases the risk of stroke by affecting the pathway leading directly to the brain. Taking warning signs such as a TIA seriously and being assessed in good time is the most effective way to prevent a permanent stroke.
If you have experienced symptoms such as sudden weakness, speech disturbance or loss of vision, even temporarily, you can make an appointment to be assessed without losing time.
References
- Naylor AR, Rantner B, Ancetti S, et al. European Society for Vascular Surgery (ESVS) 2023 Clinical Practice Guidelines on the Management of Atherosclerotic Carotid and Vertebral Artery Disease. Eur J Vasc Endovasc Surg. 2023;65:7-111.
- North American Symptomatic Carotid Endarterectomy Trial Collaborators. Beneficial Effect of Carotid Endarterectomy in Symptomatic Patients with High-Grade Carotid Stenosis (NASCET). N Engl J Med. 1991;325:445-453.