Is Bilateral Common Carotid Artery Atherosclerotic Plaque Formation Serious?

Atherosclerotic plaque formation in the bilateral common carotid arteries can vary in severity depending on individual circumstances. Below is a detailed breakdown of different scenarios and their potential seriousness:

Plaque With Stenosis

Stenosis at 50% or More

If imaging reports indicate stenosis reaching or exceeding 50%, and the patient experiences symptoms related to cerebral ischemia—such as dizziness, blurred vision, tinnitus, memory issues, or transient ischemic attacks (TIAs)—then the condition is considered significant. These symptoms may include sudden confusion or memory lapses that resolve on their own. In such cases, medical treatment is typically necessary, along with potential interventions like carotid artery stenting or carotid endarterectomy.

Stenosis at 75% or Higher

For patients with severe narrowing (75% or more), even in the absence of symptoms, intervention is often recommended. Treatment options may include either endovascular stenting or surgical removal of the plaque through endarterectomy, depending on the patient's overall health and vascular anatomy.

Near-Total or Total Occlusion

In cases of near-complete or complete blockage, even without immediate symptoms, a combination of medication and surgical or interventional procedures is generally advised. Medications such as antiplatelet agents and statins are commonly prescribed, while stenting or endarterectomy may be considered to restore blood flow and prevent stroke.

Plaque Without Significant Stenosis

When atherosclerotic plaques are present but do not cause significant narrowing, the condition is usually not considered life-threatening. However, it still requires careful evaluation. The stability of the plaque is a key factor—especially whether it is ulcerated, prone to thrombus formation, or otherwise unstable. Even mild stenosis can pose a risk if the plaque is vulnerable to rupture or if a clot is present. These types of plaques have the potential to dislodge and cause a stroke.

In such cases, it is crucial to consult with a vascular surgeon or a neurologist for further assessment and management. Early detection and treatment can significantly reduce the risk of stroke and improve long-term outcomes.