Why is it easy for plaques to form in the carotid artery and what are the dangers?

1. How do carotid artery plaques form?

Most carotid artery plaques are caused by atherosclerosis. Atherosclerosis is a chronic process that has the following four stages:

1. Early stage: lipid streaks appear in the arteries;

2. Lipid streaks further develop into fibrous plaques;

3. During the formation stage of atherosclerosis, gray-yellow plaques appear in the arteries;

4. Secondary lesions include intraplaque hemorrhage, plaque rupture, thrombosis, calcification and aneurysm formation.

Figure 1-Normal blood vessels and blood vessels with arterial plaque

2. Why is the carotid artery so prone to plaques?

The carotid artery grows on both sides of the Adam's apple, and you can feel it "beating" with your hands. All the blood in the body flows through here. Compared with other arteries, the carotid artery is narrower, and there is a "Y"-shaped bifurcation near the head and neck, where vortices are easily formed. When the blood is viscous and contains lipids, the blood flow will slow down when it flows through the relatively narrow carotid artery, and the lipids in the blood will slowly deposit on the blood vessel wall. When calcium-containing substances are deposited at the same time, plaques will slowly form. In addition, the blood flow at this branch has a strong scouring force, which can easily cause mechanical damage to the arterial endothelium, causing cholesterol to enter the blood vessel endothelium from the damaged area and form plaques. Because the carotid artery is a large artery that is relatively shallow from the body surface, if plaques appear, they can be easily discovered by ultrasound examination.

Figure 2-Carotid artery anatomy

3. What are the risk factors for carotid artery plaque?

Although there are special anatomical structures that make carotid artery plaques prone to formation, it does not form for no reason. The formation of carotid artery plaques can be divided into controllable and uncontrollable factors.

Uncontrollable factors: age, gender, genetic factors, etc.

Factors that can be controlled include: hyperlipidemia, hyperhomocysteinemia, hypertension, hyperuricemia, smoking, metabolic syndrome, hypertriglyceridemia, diabetes, and high and low-density lipoproteinemia.

Four of these risk factors (hyperlipidemia, hyperhomocysteinemia, hypertension, and hyperuricemia) can increase the risk of carotid plaque by at least 30%. Lifestyle intervention is crucial in the prevention and treatment of carotid plaque.

4. What are the dangers of carotid artery plaque?

If the carotid artery plaque is small and the carotid artery stenosis is <50%, the patient may not have obvious clinical symptoms.

If the carotid artery stenosis exceeds 50%, the patient may experience symptoms related to insufficient blood supply to the brain. More importantly, carotid artery plaque is one of the important causes of ischemic stroke (i.e. cerebral infarction).