Address: 27 Welbeck Street, London, W1G 8EN
Tel: 020 7101 3377

Stroke Bundle

Carotid stenosis and narrowing

Carotid stenosis, also known as carotid artery disease or carotid artery stenosis, is a condition characterized by the narrowing of the carotid arteries. These major blood vessels located on each side of your neck supply oxygen-rich blood to the brain. Carotid stenosis is often caused by atherosclerosis, a buildup of plaque composed of fat, cholesterol, calcium, and other substances in the artery walls. Over time, this buildup can reduce blood flow to the brain and increase the risk of stroke.


The primary cause of carotid stenosis is atherosclerosis. Risk factors for the development of atherosclerosis and carotid stenosis include:

  • High blood pressure
  • High cholesterol
  • Diabetes
  • Smoking
  • Obesity
  • Physical inactivity
  • Unhealthy diet
  • Family history of atherosclerosis or cardiovascular disease
  • Age (risk increases with age)
  • Chronic kidney disease


In many cases, carotid stenosis does not cause noticeable symptoms until it severely restricts blood flow or leads to a stroke. Symptoms of a stroke or transient ischemic attack (TIA, often referred to as a “mini-stroke”) may include:

  • Sudden weakness or numbness in the face, arms, or legs, especially on one side of the body
  • Difficulty speaking or understanding speech
  • Sudden vision problems in one or both eyes
  • Dizziness or loss of balance
  • Sudden, severe headache with no known cause
  • Difficulty swallowing


Carotid stenosis is diagnosed through various methods:

  • Physical Exam: Listening for a bruit (a whooshing sound) over the carotid artery with a stethoscope, which may indicate abnormal blood flow.
  • Carotid Ultrasound (Doppler Ultrasound): A non-invasive test that uses sound waves to create images of the carotid arteries and measure blood flow, identifying blockages or narrowing.
  • Computed Tomography Angiography (CTA) or Magnetic Resonance Angiography (MRA): These imaging tests provide detailed images of the carotid arteries and can detect narrowing or blockages.
  • Carotid Angiography: A more invasive test involving the injection of a contrast dye to visualize the carotid arteries in detail. This is often performed when a surgical intervention is being considered.


Treatment for carotid stenosis focuses on reducing the risk of stroke and may include:

  • Lifestyle Changes: Such as adopting a healthier diet, increasing physical activity, quitting smoking, and managing weight.
  • Medications: To control blood pressure, lower cholesterol, and prevent blood clots.
  • Surgical Procedures: For significant narrowing (usually 70% or more) or in cases where symptoms have already occurred, surgical options include:
    • Carotid Endarterectomy: Surgical removal of plaque from the carotid artery to restore normal blood flow.
    • Carotid Artery Angioplasty with Stenting: A less invasive procedure where a balloon is used to expand the narrowed artery, and a stent is placed to keep it open.


Preventing carotid stenosis involves controlling its risk factors through lifestyle changes and, if necessary, medications to manage conditions like hypertension, high cholesterol, and diabetes.

Carotid stenosis is a serious condition that requires prompt diagnosis and management to reduce the risk of stroke and other complications. If you are at risk or experience any symptoms suggestive of a stroke or TIA, seek medical attention immediately.

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Address: 27 Welbeck Street, London, W1G 8EN

Telephone020 7101 3377