The carotid arteries, located on each side of your neck, are major blood vessels responsible for delivering oxygen-rich blood from your heart to your brain and other parts of your head and face. A smooth, unobstructed flow of blood through these vessels is fundamental for proper brain function and overall well-being.
What is Carotid Plaque?
Carotid plaque is a buildup of various substances within the inner lining of the carotid arteries. This accumulation typically consists of fatty materials, cholesterol, cellular waste products, calcium, and fibrin. The process by which this plaque forms and hardens the arteries is known as atherosclerosis.
As atherosclerosis progresses, these plaques can grow, causing the arterial walls to thicken and become less flexible. This narrowing, or stenosis, can restrict blood flow to the brain. Pieces of plaque can also break off and travel to smaller arteries in the brain, or they can cause blood clots to form, potentially blocking the artery entirely. Such events can lead to serious complications like a stroke (when the brain is deprived of blood and oxygen) or a transient ischemic attack (TIA), often called a “mini-stroke,” which is a temporary shortage of blood flow to the brain.
How Carotid Ultrasound Works
A carotid ultrasound is a non-invasive imaging test that uses high-frequency sound waves to create pictures of the carotid arteries in your neck. This procedure is safe and does not involve radiation. The sound waves are emitted from a handheld device called a transducer, which is gently moved over the skin on your neck after a clear gel is applied.
The sound waves bounce off the arterial structures and blood cells, returning as echoes to the transducer. A computer then translates these echoes into real-time images displayed on a monitor. A specialized technique called Doppler ultrasound is integrated into the exam to measure the direction and speed of blood flow through the arteries. This allows providers to visualize artery structure, detect plaque, and assess blood movement, serving as a diagnostic tool for carotid artery disease and for evaluating stroke risk.
Understanding Your Ultrasound Results
Interpreting carotid ultrasound results involves assessing several factors that contribute to your overall stroke risk. One primary finding is “stenosis,” which refers to the narrowing of the artery due to plaque buildup. The degree of stenosis is often expressed as a percentage of blockage, categorized as less than 50%, 50-69% (moderate narrowing), or 70-99% (severe narrowing).
Beyond the degree of narrowing, the characteristics of the plaque itself provide additional insights into its stability and potential for problems. Plaques can be described by their echogenicity, how they appear on ultrasound. Hypoechoic plaques, appearing darker, often contain lipids and intraplaque hemorrhage, making them more prone to rupture and associated with higher ischemic risk. Conversely, hyperechoic plaques, which appear brighter, tend to be more stable, composed of fibrous, calcified tissue. Other features like surface irregularity, ulceration, and intraplaque motion also indicate a higher risk of stroke. These findings, combined with stenosis percentage, help your doctor assess individual stroke risk and guide appropriate management decisions.
Managing Carotid Plaque Findings
Once carotid plaque is detected through an ultrasound, management strategies are tailored to the individual’s specific findings and overall health. Lifestyle modifications are a key part of managing carotid plaque. These include adopting a heart-healthy diet, engaging in regular physical activity, quitting smoking, and managing conditions like high blood pressure and diabetes. These changes can help stabilize existing plaque and prevent further buildup.
Medical interventions often involve medications to address underlying risk factors. Statins are commonly prescribed to lower low-density lipoprotein (LDL) cholesterol, which can help stabilize plaque and reduce cardiovascular event risk. Antiplatelet drugs, such as aspirin or clopidogrel, may also be recommended to prevent blood clots on the plaque surface. For significant stenosis (e.g., 70% or more, or 50-69% with symptoms), more invasive procedures may be considered. Carotid endarterectomy surgically removes plaque from the artery, while carotid artery stenting places a small mesh tube to hold the artery open. These decisions are made in consultation with a healthcare professional, weighing benefits against risks.