2023-09-10 09:43:44
by Antonella Sparvoli
Carotid stenosis is a pathology that obstructs the vessels, preventing the correct flow of blood to the brain and face. Among the causes, high bad cholesterol, smoking, sedentary lifestyle. What are the symptoms to watch out for
Approximately 20-25% of ischemic strokes are the result of so-called carotid stenosis, an obstructive vascular disease that affects the carotid arteries, located at the base of the neck and responsible for carrying blood to the brain and face.
Why do the carotid arteries get sick?
Due to risk factors for atherosclerosis, such as high “bad” cholesterol (LDL), smoking, hypertension, diabetes and sedentary lifestyle, the lumen of the carotid arteries can experience a narrowing which leads to a lower blood supply to the brain – he explains Piero Montorsi, full professor of Cardiology at the University of Milan and director of Interventional Cardiology at the Monzino Cardiology Institute in Milan —. The lower blood flow in one carotid artery can be partly compensated by the other carotid artery and the vertebral arteries, since they also carry blood to the brain. Despite this, those with carotid stenosis run the risk that small fragments of atherosclerotic plaque (emboli), deposited on the wall of these arteries, detach and occlude the cerebral ramifications, with more or less serious damage.
Are there any warning signs?
Often it does not cause symptoms and is found by chance, other times the first manifestations are the so-called Tia (transient ischemic attack) or cerebral stroke (apoplexy), with possible greater and permanent damage. In both cases the patient may experience various symptoms, often on only one side of the body, the one opposite to the cerebral hemisphere affected by the occlusion. Possible manifestations include lack of strength in the arm and leg, speech and language disorders or ocular symptoms. In TIA the disturbances must subside within 24 hours, while in stroke they are more long-lasting and disabling.
What can be done?
If symptoms suggestive of possible cerebral ischemia occur, emergency treatment is required: the sooner you intervene, the greater the possibility of limiting the damage. Once the acute phase has passed or if the carotid stenosis is recognized in time, action can be taken to prevent future cerebral ischemia. Therapeutic possibilities are traditional open surgery and carotid stenting.
What are the main intervention techniques?
Surgical intervention or percutaneous treatment are the two most used intervention techniques. Both valid – points out Montorsi -. When there is an indication for surgery, the risk of having an ischemic stroke during the surgery is less than 1 percent and decidedly lower than what the patient would have if the disease were not treated. The benefits are long-lasting. The choice of technique is left to the evaluation and results of the individual center being addressed. The percutaneous procedure is performed from the femoral approach but, increasingly often also from the right radial one (the same used for coronary angioplasty), allowing the treatment of patients with contraindications to the femoral approach with a reduction in haemorrhagic complications, rapid post-mortem mobilization -procedure and a lower average hospital stay.
September 10, 2023 (modified September 10, 2023 | 09:42)
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