Life Expectancy With Blocked Carotid Artery

Our brain is the central command of our body. It allows interaction with the outside world and makes the body move. All this is high-energy work, which requires a constant supply of oxygen and nutrients. The main source of fresh blood for the brain is pumped into the head via two carotid arteries. In this blog, we will take a close look at what happens when one of the carotid arteries is blocked. We will explore the causes of this condition, including atherosclerosis and arterial damage, and discuss the symptoms that may indicate a blockage.
Jakub Gwiazdecki

Jakub Gwiazdecki

Fifth year medical student at the Medical Faculty of Comenius University in Bratislava.

A blue image with text saying "Life Expectancy With Blocked Carotid Artery"

What is the life expectancy with a blocked carotid artery?

Several factors influence the life expectancy of a person with a blocked carotid artery. They include the health status of the affected person, the severity of the blockage, and the chosen treatment.

Carotid stenosis can lead to serious health issues. Among the most dangerous complications that can significantly impact life expectancy is stroke. This neurovascular acute condition can reduce the life span by about one-third [1].

However, life expectancy can be improved by treatments like carotid endarterectomy (CEA). A large study of over 70,000 people treated with CEA found that less than 13% of the participants died five years after the treatment. Another study found that nearly 70% of people over 80 years old are expected to survive another 5 years or more after stent placement or CEA [2].

In the middle age group of the population aged 35 years and older, the carotid blockage lowers the 5-year survival expectancy by 8% compared to the healthy population [3].

What can cause a blockage of the carotid artery?

Atherosclerosis is the typical cause of a blocked carotid artery, or carotid artery disease. This is a condition where, with time and under negative influence, a plaque builds up and leads to occlusion. The main components of this sticky buildup in the arterial wall are cholesterol, fat, and calcium [4, 5].

Also, other diseases that lead to arterial damage can cause artery disease [5]. Among the most dangerous is carotid artery dissection. In this condition, the arterial walls split, creating a new additional space. This space in the artery can obstruct normal blood flow or even cause a blockage [6].

Risk factors for aortic dissection include

Neck trauma, recent infection, family history, smoking, hypertension, oral contraceptives, migraine headaches, and connective tissue disease.

Furthermore, among other causes of carotid artery disease are fibromuscular dysplasia, moyamoya disease, and inflammatory large vessel vasculitis [7].

Also, mechanical damage to the carotid artery can lead to its obstruction. For example, in Eagle syndrome, where the styloid process is too long, chronic irritation can cause a dissection and subsequent occlusion [8].

What are the symptoms of carotid artery blockage?

Carotid artery blockage is a serious medical condition that is very tricky. Normally, it gives very few symptoms until the severe stage of the obstruction. The changes start abruptly and should never be ignored.

One of the most common symptoms is sudden weakness or numbness in the face, arms, or legs, usually on one side of the body. Often, it is accompanied by speech articulation or understanding [5].

Another symptom is sudden vision problems. It can occur in both or one eye and can range from blurred vision to complete loss.

The abrupt onset of neurological and ophthalmological problems can be connected with dizziness and severe headaches [5].

In some cases, the affected individuals may experience drooping on one side of the face [5].

Other symptoms include memory loss, confusion, incoherent speech, and loss of consciousness [4].

In rare cases, even when the patients know what their thoughts are, they cannot pronounce them. This is because of a swollen tongue and paralysis of the nerves commanding it [9, 10].

How is a blocked carotid artery diagnosed and treated?

The diagnosis of a blocked carotid artery is made through a combination of physical examination and imaging tests. The physical examination is a fast method and includes auscultation of the carotid artery [4, 11].

Imaging methods, on the other hand, are for confirming the diagnosis. A suspected carotid artery obstruction can be confirmed by ultrasound sonography, contrast-enhanced computed tomography, magnetic resonance tomography, or digital subtraction angiography [12, 13, 4].

Often, duplex ultrasonography is chosen as a diagnostic modality. It is cheap and fast and allows the identification of a lesion in the carotid artery based on hemodynamic changes [14].

The treatment for a blocked carotid artery can vary depending on the severity of the blockage. Another determinant of the strategy is whether the patient has had a stroke.

Initial treatment of non-critical stroke patients with atherosclerosis as a causative factor involves lifestyle changes. Their implementation allows them to slow down the development of the plaque. Among the general changes prescribed are quitting smoking, regular physical activity, and a healthy diet [5].

To prevent the formation of a thrombus on the existing plaque, medications can be administered. Commonly prescribed are antiplatelet agents such as acetylsalicylic acid (aspirin), clopidogrel, or ticagrelor [15].

In severe cases, surgical interventions can be required to remove the plaque. Often, carotid endarterectomy is performed. The decisive parameter is the percentage of the occlusion. Symptomatic patients with more than 50% are recommended for surgery. For individuals without symptoms to undergo the carotid endarterectomy, more than 60% blockage is needed [16, 17]. However, the final decision has to be made individually by the doctors, and they do not always have to follow the numbers.

Another surgical option that can be considered is carotid angioplasty and stenting. During this procedure, a stent is placed at the blocked part of the artery to hold it open [5, 11]. This procedure should be performed in cases where the patient is contraindicated for carotid endarterectomy [15].

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Jakub Gwiazdecki

Jakub Gwiazdecki

Jakub is in his fifth year as a medical student at Comenius University in Bratislava, Slovakia. He has special interested in cardiology and in patient-centered medicine. His love for heart health isn't just book-smarts; he wants to know how it works, what it means for our feelings, and how key it is for health and happiness. Jakub thinks real good health care comes from always putting the patient at the centre, treating each person as a whole.