A blocked or clogged carotid artery is a dangerous condition that can increase your risk of stroke. The carotid arteries are located on each side of your neck and supply oxygen-rich blood to your brain. When one becomes blocked by plaque buildup, it can restrict blood flow and cause serious complications.
While surgery like carotid endarterectomy is often recommended for clearing severe blockages, there are also some non-surgical treatment options to consider first. Lifestyle changes, medication, and minimally invasive procedures can help clear plaque and restore blood flow in certain cases.
What causes a blocked carotid artery?
Atherosclerosis is the most common cause of a blocked carotid artery. This is a condition where plaque made of cholesterol, fat, calcium, and other substances builds up inside the artery walls over time.
As more plaque accumulates, it narrows the inside of the arteries, restricting blood flow to the brain. Pieces of plaque can also break off and form blood clots that fully block the artery and trigger a stroke.
Risk factors that contribute to atherosclerosis and increase your chances of a blocked carotid artery include:
- Older age
- Smoking
- High cholesterol
- High blood pressure
- Obesity
- Diabetes
- Lack of exercise
- Unhealthy diet
- Family history of heart disease or stroke
How do you know if you have a blocked carotid artery?
A blocked carotid artery often does not cause any signs or symptoms until it is severely narrowed or fully blocked. Symptoms generally occur suddenly on one side when blood flow to the brain is reduced.
Symptoms of a blocked carotid artery may include:
- Weakness or paralysis on one side of the body
- Numbness on one side of the face or limbs
- Blurred vision or complete vision loss in one eye
- Slurred speech or difficulty understanding speech
- Dizziness or loss of balance
- Severe headache
- Confusion
- Fainting
The presence of bruits (whooshing sounds) when your doctor listens to your neck with a stethoscope is another sign of a blocked carotid artery. A neurological exam looking for reduced functioning on one side of your body may also indicate a blockage.
Your doctor can use imaging tests like carotid ultrasound, CT scan, MRI, cerebral angiogram, or trans cranial Doppler ultrasound to confirm a blocked carotid artery and determine the location and extent of plaque buildup.
How to clear a blocked carotid artery without surgery
If you are diagnosed with a partially blocked carotid artery, there are some non-surgical treatment options your doctor may recommend trying first. Lifestyle changes, medications, and minimally invasive endovascular procedures can help clear plaque and reopen the narrowed artery in many cases.
1. Make lifestyle changes
Creating a healthier lifestyle is key for clearing any level of blockage in the carotid arteries. Making changes to your diet, exercise, smoking habits, and stress levels can prevent further plaque buildup.
Steps to take include:
- Quit smoking and avoid secondhand smoke.
- Follow a heart-healthy diet low in saturated fat, trans fat, sodium, and added sugars.
- Eat plenty of fruits, vegetables, and whole grains.
- Choose lean protein sources like fish, beans, poultry, and soy products.
- Limit processed foods, fried foods, and refined carbohydrates.
- Maintain a healthy weight by reducing calorie intake and exercising.
- Get at least 150 minutes per week of moderate exercise like brisk walking.
- Limit alcohol intake to 1 drink per day for women or 2 for men.
- Find ways to manage stress through yoga, meditation, therapy, or other relaxation techniques.
2. Take medications to lower plaque and prevent clots
If lifestyle changes alone are not enough, your doctor may prescribe medications to help clear the blockage by reducing plaque and preventing blood clots.
Medications may include:
- Statins – Lower cholesterol and stabilize plaque buildup.
- Blood thinners – Prevent blood clot formation. Aspirin is commonly used.
- Antihypertensives – Lower blood pressure and plaque rupture risk.
- Diabetes medications – Control blood sugar and decrease inflammation.
3. Try catheter-based procedures
If medications combined with lifestyle changes do not successfully clear the blockage, minimally invasive endovascular procedures may be an option.
These procedures use a thin flexible tube called a catheter that is inserted into a blood vessel in your groin or wrist. The catheter is threaded up to the blocked carotid artery to open the blockage without surgery.
Examples of catheter-based procedures include:
- Angioplasty and stenting – A small balloon on the catheter is inflated to push plaque outward. A wire mesh stent may be left in place to prop the artery open.
- Atherectomy – A tiny cutting blade, laser, or high-pressure water on the catheter is used to shave or vaporize plaque from the artery walls.
- Embolic protection device – A special filter may be used to capture dislodged particles and prevent embolic stroke during the procedure.
These minimally invasive procedures have good short-term success rates, but plaque buildup can recur over the long term and require repeat procedures.
When is surgery recommended for a blocked carotid artery?
If you have a severely narrowed carotid artery that is restricting blood flow by 70% or have a full blockage, surgery may be recommended to fully restore blood flow and decrease stroke risk.
The standard surgery is called carotid endarterectomy. This procedure involves making an incision in your neck to open up the blocked carotid artery. The surgeon will:
- Remove plaque buildup and blood clots from inside the artery
- Repair any damage to the artery walls
- Close the artery with stitches
Carotid endarterectomy has excellent long-term results for keeping the artery open. Around 5% of people may have stroke symptoms return down the road and need a repeat procedure.
Rarely, carotid angioplasty and stenting may be done instead which avoids any neck incision, but has a higher risk of stroke right after the procedure.
Who needs carotid artery surgery?
Carotid surgery is generally recommended if:
- You have a severe blockage over 70% that is not responding well to other treatments
- You have a full or near-total carotid blockage
- You are experiencing stroke-like symptoms from a severe blockage
- Plaque is unstable and could break loose and cause a stroke
In general, the benefits of surgery outweigh the risks when carotid artery narrowing reaches 70-99%. It is a very effective preventive treatment for stroke.
What are the risks of carotid artery surgery?
All surgeries carry some risks. For carotid endarterectomy, the main risks include:
- Stroke – Occurs in about 3% either during or soon after surgery
- Heart attack
- Infection
- Nerve injury that can cause issues swallowing
- Bleeding or hematoma
- Damage to internal carotid artery
Choosing a surgeon with a great deal of experience performing carotid endarterectomies can help minimize these risks. Make sure to discuss both the benefits and risks with your doctor.
Recovering from carotid artery procedures
Regardless of whether you have a catheter-based procedure or surgery, following your doctor’s post-procedure instructions carefully is important for recovery.
Typical recommendations include:
- Get plenty of rest and avoid strenuous activity for 1-2 weeks.
- Take any prescribed medications like antiplatelet drugs to prevent blood clots.
- Make lifestyle changes like eating a healthy diet, exercising, and quitting smoking to keep your arteries clear.
- Attend follow up appointments so your doctor can monitor your progress.
- Report any concerning symptoms right away like swelling or bleeding at the incision site, fever, weakness, or confusion which could indicate complications.
Following carotid artery procedures, most people are able to return to their normal routines within a couple weeks. By maintaining healthy lifestyle habits long-term, you can keep your carotid arteries clear and decrease your risk of repeat blockages or stroke.
Conclusion
A blocked carotid artery is a serious health condition that calls for prompt medical attention to prevent a potentially disabling stroke. While surgery is often necessary for severe blockages, other options like lifestyle changes and medications can help clear plaque in the early stages.
Working with your doctor to implement healthy habits and control risk factors that contribute to carotid artery disease is crucial for prevention. With proper treatment, it is often possible to restore normal blood flow and avoid complications from a blocked carotid artery.