CAROTID ARTERY STENOSIS: Causes, Signs and Treatment!
WHAT IS CAROTID ARTERY STENOSIS?
Carotid Artery Stenosis Definition: Carotid artery stenosis (occlusive disease of the neck arteries) describes a diseased alteration which leads to the partial blockage or complete closure of this vessel. Such changes can affect all brain-serving impact aids. These are the carotid arteries, the external carotid artery and the internal carotid artery, as well as the vertebral arteries.
Stages of Carotid Artery Stenosis:
The disease signs of occlusion processes in the area of the brain-feeding neck arteries are divided into stages independently of the affected vascular area:
- Stage I: Carotid artery stenosis can remain asymptomatic, vasoconstriction or occlusion can only be detected by accident, for example by ultrasound examination of the neck.
- Stage II: Symptomatic carotid artery stenosis is seen as a temporary disorder characterized as a transient ischemic attack for less than 24 hours, or as a prolonged ischemic neurological deficit.
- Stage III: Contains the manifest stroke with increasing or decreasing neurological symptoms, which progresses within 6 – 48 hours.
- Stage IV: Indicates the past stroke with permanent symptoms of different manifestations.
WHAT ARE THE CAUSES OF CAROTID ARTERY STENOSIS?
Carotid Artery Stenosis Causes: The cause of the throat is in 85% of all cases the vessel lime ( arteriosclerosis ) in brain-supplying arteries. The risk factors are: smoking, hypertension, diabetes mellitus, increased blood lipid and high age. In arteriosclerosis, deposits of lime and/or fatty substances occur on the inner wall of the vessel. These deposits can slowly from within the natural ageing process as wear phenomena and narrow the vessel illumination or can completely close it.
Risk factors leading to arterial occlusions and occlusions are:
- High blood pressure Normal value: up to 130/85 mmHg
- Fat metabolism disorders Normal values: cholesterol LDL cholesterol HDL cholesterol 45 mg/dl, – triglycerides
- To smoke cigarettes
- Blood glucose level Normal values: Fasting blood glucose below 110 mg/dl
- Familial disposition (hereditary condition to atherosclerosis)
WHAT ARE THE SYMPTOMS OF CAROTID ARTERY STENOSIS?
Carotid Artery Stenosis Symptoms: Carotid stenosis can be asymptomatic ( stage I ), ie, without discomfort. It is usually determined during a routine examination. Such examinations are particularly carried out in patients with arteriosclerosis of the heart vessels. Symptomatic carotid stenosis ( stage II-IV ) manifest themselves in clinical failure. Typical symptoms are speech disorders, paralysis and sensory disturbances on the face, arms and legs, blurred vision and dizziness. Frequently, these symptoms are only temporary and are formed.
Signs of disease with constrictions or occlusions in the region of the brain-feeding neck arteries are:
- Dual Image View
- Rotational dizziness
- Speech, swallowing, hearing disorders
- Half-sided visual field loss, ie the patient no longer sees in the entire right or left part of the visual field
- Paralysis of one or all four limbs
- extensor spasms
WHAT IS THE TREATMENT FOR CAROTID ARTERY STENOSIS?
Carotid Artery Stenosis Treatment: The aim of the treatment in the detection of a carotid stenosis is to avoid a stroke. Depending on the degree of stenosis and the symptoms, conservative or operative and interventional therapy is available. Basically, a carotid stenosis is treated if a constriction of> 70% is present in symptomatic stenosis and a constriction of> 75% in an asymptomatic stenosis.
- Carotid Artery Stenosis Medicition: The conservative therapy consists in the administration of so-called thrombocyte aggregation inhibitors (eg acetylsalicylic acid, Clopidogrel). These prevent clumping of blood platelets and reduce the risk of blood clot formation in the throat with the risk of occlusion and clogging of the clot into the brain (embolism).
- Carotid Artery Stenosis Surgery: The principle of operative therapy is based on the local removal of the arteriosclerotic plaque known as desobliteration. There are different techniques of peeling, which do not differ significantly with respect to the results. In the classical method (TEA with patchplasty), the vessel is opened longitudinally and the throat is excised. The longitudinal opening is closed with a stripped plastic (patch). Alternatively, an eversion peeling can be carried out. In doing so, the artery is deposited on the fork and the outer vessel wall is inverted so that the plaque can be removed. The cleaned vessel is then sewn into the fork. In both methods, access is made via a small skin cut at the neck side. In order to avoid intraoperative stroke, different methods of monitoring are used: somatosensory evoked potentials (SSEP), stump pressure measurement and transcranial Doppler (TCD). However, an improvement of the surgical results is not proved by the monitoring. If a change in the monitoring occurs during the disconnection phase, a shunt should be inserted. This provides a further supply of blood to the brain.