Stenosis and obstruction of carotid is directly related to loss of some cerebral functions and stroke resulting in temporary or permanent paralysis. It commonly occurs with other cardiovascular diseases because the most important cause is atherosclerosis.
- Advanced age,
- Diabetes mellitus,
- Family history of a cardiovascular disease are the factors increasing the risk.
Symptoms and Consequences:
Many carotid narrowing or obstructions are asymptomatic. It may be detected on the color Doppler ultrasonography which is performed for control. Temporary or permanent paralysis may occur in some patients. This may present with permanent or temporary visual loss, speech disorder, and paralysis of extremities.
The primary cause is that particles come off from the plague, which narrows the vessel, and obstructs the circulation in some part of the brain. Loss of functions of this cerebral part with impaired circulation occurs. These symptoms are temporary if it is mild and called Temporary Ischemic Attack (TIA). These symptoms may be permanent in some group of patients. Some portion of this patient group will dye while the other portion will require care.
The imaging methods are used to make final diagnosis after listening to patient complaints and performing physical examination.
- Color Doppler ultrasonography of the neck,
- CT angiography
- Classical angiography are the imaging methods in diagnosis.
Open surgery (carotid endarterectomy) or close (endovascular) method can be applied on suitable patients.
An open surgery can be performed by local, spinal, or general anesthesia. The plague causing the stenosis is surgically removed. The patient needs to stay in the hospital for 2-3 days.
In endovascular method, the inguinal region is locally anesthetized and the inguinal artery is accessed by a specific needle. An angiography is taken to locate the stenosis. A temporary filter is inserted to prevent from small particles from passing into cerebral bloodstream prior to stent. Then a stent (metal tube) is placed into the narrowed area to enlarge the stenosis. Stenting procedure is as successful as an open surgery. The patient needs to stay in the hospital overnight.