What to do about cervical artery plaque

Cervical artery plaque is a common clinical disease. It is a mass-like structure and many factors may lead to the occurrence of cervical artery plaque. The problem of what to do with cervical artery plaques must be treated from multiple aspects simultaneously. In addition to drug treatment, attention should also be paid to improving lifestyle.

1. Lifestyle changes include quitting smoking, increasing exercise, controlling weight, and eating a low-salt and low-fat diet.

2. Medication

(1) Control blood pressure, blood sugar, and blood lipids;

(2) Antiplatelet therapy: The preventive use of antiplatelet drugs can significantly reduce the incidence of ischemic cerebrovascular disease. Aspirin or clopidogrel can be taken orally daily.

(3) Intensive lipid-lowering therapy: Many clinical studies have confirmed that statins can stabilize plaques and significantly reduce the incidence and mortality of cardiovascular and cerebrovascular events. Statins can be used to control blood lipids as appropriate based on the patient's LDL-C level and whether other risk factors for ischemic stroke are present. During the medication process, changes in liver enzymes and muscle enzymes need to be monitored regularly.

3. Surgery

The goal of surgical treatment is to prevent the occurrence of ischemic stroke. Clinically, doctors will decide whether to perform surgery and what surgical method to use based on the degree of vascular stenosis caused by carotid artery plaques, the stability of the plaques, and the patient's symptoms and basic condition.

(1) Carotid endarterectomy (CEA): This surgery removes the thickened carotid intima and sclerotic plaques. It is usually performed under general anesthesia and requires that the patient does not have severe heart, lung or other systemic diseases.

(2) Carotid artery stenting (CAS): This is a minimally invasive surgery that involves placing a stent at the site of the lesion to prop open the narrowed blood vessel wall and restore blood flow to the lesion. It can be performed under local anesthesia and is suitable for patients with severe underlying diseases who cannot tolerate general anesthesia. Dual antiplatelet therapy with oral aspirin and clopidogrel is required 3 to 5 days before surgery. It is currently believed that the long-term patency rate of CAS is the same as that of CEA.