Atherosclerosis of the carotid artery

Atherosclerosis, a disease affecting the large- and medium-sized vessels, is present in every human being. Atherosclerotic plaques can directly or indirectly cause obstruction of the arterial blood supply, causing ischemic damage distal from the occlusion. Atherosclerotic plaque development is influenced by the interplay between systemic parameters, like cholesterol levels, and local factors, like turbulent flow. This phenomenon makes atherosclerotic disease and its consequences similar, but not identical, in different vascular beds. In this chapter we will describe the unique features of carotid atherosclerosis. The pathophysiology of the atherosclerotic disease in the carotid artery is unique due the local anatomy and the role of the carotid artery in supplying the brain. We will describe the atherosclerotic disease of the carotid artery by starting at the molecular level, then describing vulnerable plaques and the unique features of carotid atherosclerosis, and end by discussing the influence of risk factors in carotid atherosclerosis.