Carotid artery stenosis, also known as carotid stenosis, refers to the narrowing of the carotid artery. This artery is one of the main blood vessels that supply the brain with oxygen-rich blood.
The treatment of carotid artery stenosis depends on the extent of the stenosis and the patient’s general state of health. There are several approaches:
Drug therapy:
In the case of mild to moderate narrowing, drug treatment must be considered. Blood thinners that reduce platelet activity, cholesterol-lowering drugs (statins) and medication to lower blood pressure must be taken if there are corresponding risk factors; blood sugar control and smoking cessation are further important measures to slow down the progression of the narrowing and reduce the risk of stroke.
Invasive interventions:
An invasive procedure may be necessary if the narrowing is greater than 70% or if symptoms occur:
Endarterectomy:
The carotid artery is opened and the plaque deposits are removed. This is a proven procedure for restoring blood flow and has been shown in many studies to be superior to conservative therapy and stenting – particularly in the case of symptomatic narrowing and asymptomatic narrowing in patients over the age of 72 – because it causes fewer strokes.
Carotid stenting:
A stent is inserted into the narrowed artery via a thin wire and deployed in order to widen the narrowing and keep it open and reduce the risk of embolism.
A narrowing is usually caused by the accumulation of plaques, which are a result of atherosclerosis. These plaques can significantly impair the blood supply to the brain by detaching material. This results in a reduced supply of blood to the area of the brain into which the material is flushed, with the consequences being either brief strokes (transient ischaemic attacks – TIA) or strokes that last for several hours or are permanent.
Carotid artery stenosis often goes unnoticed for a long time, as it does not cause any symptoms in the early stages. The warning signs that may indicate a symptomatic, embolising narrowing include
Sudden visual disturbances:
Temporary loss of vision in one eye.
Speech disorders:
Difficulty finding words or speaking.
Weakness or numbness:
Especially on one side of the body (arm or leg).
Dizziness or loss of balance:
A feeling of light-headedness or unsteadiness.
Prevention is the key to minimising the risk of carotid artery stenosis and stroke. Here are some measures that can help:
Healthy diet:
A balanced diet rich in fruit, vegetables, wholemeal products and healthy fats can help to lower cholesterol levels and keep blood vessels healthy.
Regular exercise:
Regular physical activity promotes heart health and helps prevent high blood pressure and obesity, both risk factors for carotid artery stenosis.
Quit smoking:
Smoking is a major risk factor for the development of arteriosclerosis, which leads to carotid artery stenosis. Quitting smoking is one of the most important preventive measures.
Control blood pressure and cholesterol:
Regular monitoring and, if necessary, treatment of high blood pressure and high cholesterol levels help to keep blood vessels healthy.
Regular check-ups:
Regular check-ups are particularly important for people at increased risk, e.g. due to age, family history or existing cardiovascular disease. A simple ultrasound of the carotid artery can detect a carotid artery stenosis at an early stage.
Conventional and endovascular treatment of the supraaortic branches
Surgical, endovascular and combined (hybrid) treatment of constrictions, occlusions and aneurysms of the brachiocephalic trunk
Surgical, endovascular and combined (hybrid) treatment of aneurysms of the common and internal carotid arteries
Surgical and endovascular treatment of symptomatic and asymptomatic narrowing of the internal carotid artery
Surgical treatment of symptomatic constrictions and occlusions of the vertebral artery (vertebral artery transposition, C1 bypass)
Surgical and endovascular treatment of constrictions and occlusions of the subclavian artery (subclavian artery)
Biopsy of the temporal artery
