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Carotid artery disease (CAD), sometimes called carotid stenosis, is a narrowing of the carotid arteries, the primary arteries that provide blood to the brain. This progressive atherosclerosis is usually asymptomatic until it reaches a critical degree of stenosis (>70%) and leads to impaired flow, increasing the risk of transient ischaemic attack (TIA) or stroke.

Symptoms are usually unilateral and transitory; e.g., sudden paralysis of the face/arm, trouble speaking, loss of vision, disorientation, or confusion in a TIA. Risk factors include high blood pressure, high cholesterol, smoking, diabetes, obesity, and age > 65 years, with males being much more susceptible.

The diagnosis begins with listening for a neck bruit using a stethoscope. Ultrasound, CT/MR angiography or cerebral angiography are used to assess the exact degree of stenosis. Lifestyle is stressed for moderate cases: cease smoking, eat heart-healthy foods, exercise, and control weight.

Moderate blockages are treated with antiplatelets (e.g., aspirin), statins, and antihypertensives to stabilise plaques and prevent clots. Severe cases (70% blockage after a TIA or stroke) can be treated by surgically removing the plaques (carotid endarterectomy [CEA]) or by using angioplasty with stenting in people at high risk.

Immediate therapy can reduce your risk of stroke by two-thirds. And regular checks of your blood vessels can help prevent strokes, too. CAD causes thousands of deaths each year from embolic strokes. Patients should be watchful for early indications.