How To Treat And Prevent Carotid Stenosis

March 4, 2024

Carotid stenosis happens when the carotid arteries narrow over time. Much like other types of artery disease, carotid stenosis is caused by plaque or cholesterol deposits and fatty substance build up in the carotid arteries. These arteries are what give the front of the brain its oxygenated supply of blood. There are two carotid arteries, and they are the lifeline to the part of the brain that controls speech, sensory functions, thinking functions, personality, and motor functions. When carotid stenosis occurs, there is decreased blood flow to the brain, which can cause a stroke. A stroke happens when the brain is cut off from blood flow due to a broken off piece of plaque, a blood clot that gets stuck, or when an artery narrows to the point of being fully blocked. Strokes can cause permanent brain damage or death, and individuals with carotid stenosis are at a much higher risk of experiencing one.

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Carotid Endarterectomy

Carotid endarterectomy procedures are recommended for patients who have a moderate to severe case of carotid stenosis with a blockage of between fifty and one hundred percent. When this procedure is carried out, the patient is given local or general anesthesia and the surgeon makes an incision on the neck to access the affected carotid artery. The surgeon makes another incision to the artery itself to extract the plaque inside of it causing the narrowing or clogging. Once they extract as much plaque as they can, they stitch up the carotid artery, sometimes using a patch graft to do so. An endarterectomy can also be done with a technique called carotid eversion endarterectomy, in which the surgeon cuts the artery and removes the plaque after the artery has been turned inside out. Once the plaque has been extracted, the surgeon will then reattach the artery to itself. While this procedure is relatively successful, the plaque can still build up and accumulate on the artery walls again over time.

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Carotid Angioplasty And Stenting

Carotid angioplasty and stenting is done when there is a carotid artery blockage of seventy percent or greater. This procedure is ideal for individuals who have had a stroke before and are not stable enough to have surgery performed in the neck. Sometimes the angioplasty and stenting are done when another blockage develops after a carotid endarterectomy. Sometimes this approach is used in cases where the carotid blockage is in a location that is too difficult to perform an endarterectomy on. In this procedure, a catheter with a small balloon attached is inserted into the affected carotid artery and inflated. This allows the artery to be widened and for blood to freely flow into the brain. Then a stent is placed in the artery to hold it in place so the artery does not narrow again. A stent is a metal coil that fits comfortably into the artery. While this procedure is also successful in the short term, the plaque can begin to build up after the procedure again in the carotid artery. Usually, patients are put on blood thinners after the stent placing to prevent blood clots.

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Medication For Blood Pressure And Cholesterol

High blood pressure is a huge risk factor for developing carotid stenosis, so it is very important for patients to take medication to manage it properly. With high blood pressure, the blood flows throughout the arteries with greater stress and stronger force than usual, which results in damage to the artery walls. This damage can allow bad cholesterol to penetrate the walls and start building up inside of the arteries. Without the damage to the arteries, bad cholesterol cannot permeate the artery walls. This plaque itself is made up of cholesterol, fibrous tissue, calcium, and cellular debris. Having high cholesterol in the blood or high low-density lipoprotein cholesterol means the cholesterol is present to build up in the arteries if it is able to permeate through the artery walls. Cholesterol levels increase when an individual eats foods with high levels of saturated fat. This low-density lipoprotein cholesterol comes from greasy foods and fatty deposits in meats. In addition to lifestyle diet changes, taking medication for blood pressure and cholesterol will help decrease the risk of developing carotid stenosis or having a stroke as a complication of carotid stenosis.

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Maintain A Healthy Weight

In order to maintain a healthy weight, an individual has to eat a healthy diet and exercise regularly. A diet high in fruits, lentils, chickpeas, whole grains, olive oil, vegetables, and beans will help with healthy weight management, lower cholesterol, and reduce blood pressure. Obesity is associated with a high amount of fatty tissue present in the body. Because the blockages of the carotid arteries in carotid stenosis are made from fatty tissue and other components, having a high body mass index indicates a higher fat ratio throughout the body. A high fat ratio increases the risk of developing carotid stenosis. In addition, obesity alone carries a significantly higher risk of experiencing a stroke, and that risk can be compounded by high blood pressure and or a carotid stenosis diagnosis. Overweight individuals put more pressure on the arterial walls because the blood cannot flow as easily through the arteries, meaning they have to compensate for that. The increased stress on the arteries can result in high blood pressure and damage to the arterial wall.

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Control Chronic Diseases

Chronic diseases that contribute to the development of carotid stenosis include diabetes, hypertension, and sleep apnea. Diabetes is a huge risk factor in the development of carotid stenosis because of the harsh effects high blood glucose has on the arterial walls. Carotid arteries can be significantly damaged and inflamed as a result of chronic high blood sugar. This happens in individuals who have diabetes but do not control it as they should with diet, exercise, and medications. In addition, hypertension is another chronic disease that causes mass damage to the arterial walls, and it should be managed by taking medication and eating a healthy diet. Sleep apnea happens when an individual stops breathing temporarily during their sleep at night. Because they stop breathing briefly, the brain does not get adequate blood flow, and the cardiovascular system attempts to compensate for that. This can cause plaques to break off and get stuck in the carotid arteries resulting in a stroke. Management of sleep apnea is imperative to stroke prevention in patients who have carotid stenosis. If it is just a mild case of carotid stenosis, keeping control of chronic diseases, and eating a healthy diet may be able to treat the condition without medical procedures.

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