Carotid occlusive disease
What is it?
The disease affects the blood vessels that carry blood to the brain. The formation of atheromatous plaques in the internal carotid artery causes it to narrow, preventing the blood from flowing freely and supplying the brain with enough blood. Small fragments may also detach from these plaques and embolise in the cerebral arterial vessels. Both of these mechanisms can lead to ischaemic brain stroke. People with other pre-existing cardiovascular diseases and associated risk factors (high blood pressure, smoking, diabetes, dyslipidaemia) or people with a positive family history of atherosclerotic disease or cerebral strokes are most at risk. Age is also a risk factor: patients over the age of 50 are more likely to have the disease.
Which are the symptoms?
In many cases carotid artery disease is asymptomatic until cerebral ischaemia develops. It is therefore crucial to include carotid artery studies in cardiovascular disease screening programmes, especially in people with one or more risk factors. In other cases, people suffering from this pathology may experience
- impaired sensation and mobility in extremities
- temporary visual disturbances
- speech disorders
- transient ischaemic attacks or TIAs (temporary damage to brain cells due to lack of oxygen)
- stroke or cerebral infarction (death of brain cells due to lack of oxygen)
How is it diagnosed?
Carotid stenosis is often asymptomatic, so screening of the carotid arteries is necessary in patients over 55 years of age with cardiovascular risk factors.
How is it treated?
There are various types of treatment: drug therapy is carried out to prevent the progression and symptoms of non-serious carotid stenosis (antiplatelet agents); surgical treatment is carried out and proven by many years of experience, it consists of removing the atheromasic plaque directly through an incision in the carotid artery under local anaesthetic; endovascular treatment is carried out only in selected cases, and is in fact the method of choice only for patients who may not undergo surgery for technical reasons or for reasons related to health status.
Where do we treat it?
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