What Is the Best Treatment for Carotid Artery Stenosis?

Medically Reviewed on 1/31/2023
Treatment for Carotid Artery Stenosis
Carotid artery disease is caused by the accumulation of plaques in either of the two carotid arteries.

The best treatment of carotid artery stenosis usually involves a combination of medications, lifestyle changes, and surgery (if needed) to halt or delay the progression of the disease.

The treatment of carotid artery disease aims to prevent stroke.

Depending on the extent of blockage in the carotid arteries, specific treatment options include:

  • Medications
  • Lifestyle changes
  • Surgery
    • Carotid endarterectomy: The most common treatment for severe carotid artery disease, wherein an incision is made along the front of the neck, and the plaque is removed from the affected carotid artery. The artery is finally repaired with either stitches or a graft.
    • Carotid angioplasty and stenting: A tiny balloon is threaded by a catheter to the area of the clog under local anesthesia. The balloon is inflated to widen the artery, and a stent (small wire mesh coil) is inserted to prevent the artery from narrowing again.

What is carotid artery stenosis?

Carotid artery stenosis or carotid artery disease is a slowly developing condition that occurs due to the accumulation of fatty cholesterol deposits (plaques) and clogs the blood vessels that deliver blood to the brain and head (carotid arteries).

This blockage increases the risk of stroke, a medical emergency that occurs when the blood supply to the brain is interrupted, depriving it of oxygen.

According to the American Stroke Association, stroke is the fifth most common cause of death and the leading cause of permanent disability in the United States.

The first sign of carotid artery stenosis is often a stroke or a transient ischemic attack (TIA). A TIA is a temporary shortage of blood flow to the brain.

Depending on the extent of blockage, carotid artery stenosis is classified into three groupings:

  1. Mild: Less than 50 percent blockage
  2. Moderate: 50 to 79 percent blockage
  3. Severe: 80 to 99 percent blockage

What causes carotid artery stenosis?

Carotid artery disease is caused by the accumulation of plaques in either of the two carotid arteries (located on each side of the neck), which blocks the normal flow of blood to the brain, face, and head. This process of building and blocking the arteries is called atherosclerosis.

Plaques are made up of clumps of cholesterol, calcium, fibrous tissue, and other cellular debris accumulating at the microscopic injury sites within the affected artery. 

Carotid arteries that are clogged with plaques are hard and narrow, leading to trouble delivering oxygen and nutrients to vital brain structures responsible for day-to-day functioning.


In the U.S., 1 in every 4 deaths is caused by heart disease. See Answer

What are the risk factors for carotid artery stenosis?

Factors that may increase the vulnerability of carotid artery disease include:

What are the signs and symptoms of carotid artery stenosis?

In its early stages, carotid artery disease may not cause any symptoms or only milder symptoms. The condition may go unnoticed until the brain is seriously deprived of blood, causing a stroke or transient ischemic attack (TIA).

A person with a stroke or TIA may experience symptoms such as:

  • Sudden numbness or weakness (decreased muscle strength) in the face or limbs (often on one side of the body)
  • Trouble speaking/slurred speech
  • Trouble understanding (confusion) and communicating with others
  • Loss of coordination or movement
  • Temporary loss of vision in one or both eyes
  • Sudden dizziness or loss of balance
  • Severe headache (with no apparent cause)

How is carotid artery stenosis diagnosed?

Apart from a thorough medical history and physical examination, which involves listening for a swooshing or whistling sound (bruit) over the carotid artery in the neck (a sound that's characteristic of a narrowed artery), the doctor may recommend the following tests:

  • Ultrasound: To assess blood flow and pressure in the carotid arteries using sound waves
  • CT scan or MRI scan: To analyze the evidence of stroke or other abnormalities
  • Computed tomography angiography or magnetic resonance angiography: To provide additional images of blood flow in the carotid arteries using an injectable dye to help show any blockages on the images.
Medically Reviewed on 1/31/2023
Image Source: iStock image

Carotid artery disease Mayo Clinic https://www.mayoclinic.org/diseases-conditions/carotid-artery-disease/symptoms-causes/syc-20360519

Carotid Artery Disease (Carotid Artery Stenosis) Cleveland Clinic https://my.clevelandclinic.org/health/diseases/16845-carotid-artery-disease-carotid-artery-stenosis

Carotid Artery Disease Johns Hopkins Medicine https://www.hopkinsmedicine.org/health/conditions-and-diseases/carotid-artery-disease

Treatment of Carotid Artery Stenosis: Medical Therapy, Surgery, or Stenting? NIH https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2665982/