Carotid
Stenosis
Carotid stenosis is a medical condition where the carotid artery
becomes narrow or blocked. The carotid arteries are located on each
side of your neck and they supply blood to your brain. When you have
cardiovascular disease, these vessels can be affected in the same way
as the coronary arteries and it can cause serious complications.
The stenosis develops when plaque builds up on the lining of the
arteries. Fatty material and cholesterol
accumulates on the artery walls,
becomes thick and hardens. As the build up grows larger, the flow
of blood through the artery is blocked. Some of the causes
of the plaque that leads to carotid stenosis include: diabetes, high
cholesterol, high blood pressure, heart disease, kidney
disease and a family history of stroke.
Two rare conditions can cause abnormal growth of the cells in the
carotid arteries that leads to blockage. These are fibromuscular
dysplasia and Marfan syndrome.
Symptoms
During the early stages of stenosis, you probably won't experience
symptoms. Only when the blockage becomes so severe that it interferes
with normal blood flow will symptoms appear. You may begin to
experience transient ischemic attacks. These kind of attack occurs when
there
is a problem with blood flow to the brain and a temporary decrease in
brain function results. The symptoms are similar to those of a stroke
except they only last for a couple of hours. The stenosis can
result in a real stroke as well. The symptoms you may experience
consist of: confusion, memory loss, loss of sensations, blurry vision,
problems speaking and weakness over part of the body.
Diagnosis
When you have carotid stenosis, your doctor can hear a distinctive
sound, called a bruit, when he places a stethoscope over the arteries
in your neck. Imaging tests like a magnetic resonance angiography or
computerized tomographic angiography can be used to scan the vessels in
your neck to locate the blockages. In addition, an ultrasound of the
carotid arteries called a carotid duplex, or carotid doppler, can help
your doctor determine how well the blood is flowing through your
arteries.
Treatment
If you are experiencing a few symptoms or none, your doctor may advise
waiting and watch approach to your stenosis. During this time you
will try to reduce the amount of plaque build up through dietary and
lifestyle changes. When carotid stenosis is advanced, a surgical
procedure called a carotid endarterectomy is sometimes indicated. With
this procedure, a surgeon opens your carotid artery, removes the
plaque, and then stitches the artery closed again, thereby removing the
obstruction.
A less invasive surgery is angioplasty and stenting. With
this, the surgeon makes an incision on your upper thigh and inserts a
long flexible tube into the artery and threads it up to the obstruction
in your carotid artery. A balloon is then blown up to press against the
artery and widen it. A stent is then inserted that will hold the artery
in an open position.
Prevention
You can help prevent carotid stenosis by reducing the amount of
circulating fat and cholesterol in your blood. It requires eating a
healthy low fat diet and getting regular exercise. In addition, you
should monitor your cardiovascular health by checking your blood
pressure and cholesterol levels regularly.
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