What is carotid atherosclerosis?
Carotid atherosclerosis is a state in which large blood vessels in the neck, called the carotid arteries, narrow or completely block off. The carotid arteries depart from the aorta, then pass through the neck, and then into the cranial cavity, carrying blood to the brain.
Atherosclerosis of the carotid arteries often develops in the elderly. Only 1% of adults aged 50-59 have significant narrowing of the carotid arteries, but by the age of 70, already 10% of patients have this disease.
Normally, the arteries have a smooth and even surface from the inside. But with atherosclerosis, a loose substance consisting of cholesterol, calcium and fibrous tissue is deposited in the artery wall, forming an atherosclerotic plaque, which narrows the vessel’s lumen. Atherosclerotic plaque can grow, significantly altering the normal flow of blood through an artery. In addition, its surface can be destroyed, as a result of which the smallest pieces of the plaque contents break off and close the brain vessels. This results in the stroke development.
The risk of developing atherosclerosis can be significantly reduced by quitting smoking. In addition, you must:
- keep an active lifestyle (regular exercise);
- follow a low cholesterol diet;
- control your weight.
If you have diabetes mellitus, high blood pressure, blood cholesterol, you need to take a number of additional measures to reduce the risk of atherosclerosis.
What are the symptoms of carotid atherosclerosis?
Atherosclerosis of the carotid arteries may not appear in any way in the early stages. Unfortunately, very often the first manifestation of this disease is a stroke. However, in a number of patients, the development of a stroke is preceded by the so-called transient ischemic attacks (TIA). In this case, temporary symptoms of impaired cerebral blood supply appear (lasting from several minutes to 1 hour):
- feeling of weakness, numbness, or tingling in one side of the body, such as in the right arm and leg;
- inability to control movements in the arm or leg;
- loss of vision in one eye;
- inability to speak clearly.
These symptoms usually resolve completely within 24 hours. However, you shouldn’t ignore them.
The occurrence of the symptoms described above means that there is a very high risk of developing a blood stroke. You must immediately consult a doctor. If these symptoms persist within a few hours, then this indicates the stroke development. You must immediately consult a doctor.
What research needs to be done?
During the conversation, the doctor should talk about your complaints, as well as whether you smoke or not, and whether you have rises in blood pressure.
The doctor will also ask when and how often complaints appear. On examination, the doctor will examine the area above the carotid arteries using a phonendoscope, to assess whether the noise appears when blood passes through the narrowed vessel.
To confirm the presence of carotid atherosclerosis, a special study is performed – duplex scanning. In most cases, this study is enough to determine how much the arteries are affected and choose a treatment method. However, in some cases, it is necessary to perform computed tomography (CT), magnetic resonance imaging (MRI), or angiographic examination.
The choice of a treatment option is based on the degree of damage to the carotid arteries, the presence or absence of symptoms, as well as the general state of the patient. In the early stages, a specialist may recommend medication and lifestyle changes.
In the presence of concomitant diseases in which the atherosclerosis development is accelerated, additional recommendations will be given. For example, with diabetes, it is necessary to control normal blood sugar levels. If you have high blood pressure, your doctor will prescribe medications to normalize it. If you smoke, you must quit it as fast as possible. If the blood cholesterol level is elevated, you must keep a special diet, sometimes special drugs (statins) are prescribed to lower the cholesterol level.
If there is significant damage to the carotid arteries, surgery may be required. Symptoms of a severe disease are transient ischemic attacks, a recent stroke. However, in a significant number of patients, complaints may be absent even with very severe damage to the carotid arteries.
Surgery involves removing the atherosclerotic plaque. This procedure is called carotid endarterectomy.
As our experience shows, this operation, in the hands of experienced specialists, is quite safe and, as a rule, is not accompanied by complications.
Along with traditional operations for atherosclerosis of the carotid arteries, newer methods of treatment can be applied. These include balloon angioplasty and stenting.
This method involves inserting a long, narrow tube called a catheter through a small puncture of an artery in the thigh or shoulder, into the lumen of the carotid artery. The catheter is passed to the site of narrowing of the vessel, where a special metal device – a stent – is set. The stent widens the lumen of the artery and serves as a scaffold that keeps normal vessel patency.
Currently, this technique is used mainly in patients with severe concomitant diseases (for example, heart failure), for whom conventional surgery is associated with a high risk of complications.
Arteriosclerosis vs atherosclerosis
Atherosclerosis should be distinguished from arteriosclerosis, which denote sclerosis of the arteries, regardless of the cause and mechanism of its development. Atherosclerosis is just a type of arteriosclerosis, reflecting disorders of lipid and protein metabolism (metabolic arteriosclerosis).
Depending on the etiological, pathogenetic and morphological signs distinguish the following types of arteriosclerosis:
- atherosclerosis (metabolic arteriosclerosis);
- arteriosclerosis, or hyalinosis (for example, with hypertensivedisease);
- inflammatory arteriolosclerosis (for example, syphilitic,tuberculous);
- allergic arteriosclerosis (for example, with nodularperiarteritis);
- toxic arteriosclerosis (for example, adrenaline);
- primary calcification of the middle lining of the arteries (media calcification Menckeberg);
- age-related (senile) arteriosclerosis.