How to treat carotid artery stenosis

Carotid artery stenosis can cause poor blood circulation in the carotid artery, which can easily cause symptoms of hypoxia and dizziness. The problem of carotid artery stenosis needs to be improved. Generally, the treatment of carotid artery stenosis requires medication, such as proper exercise and diet control. Carotid artery stenosis can lead to bleeding and arteriosclerosis. It is hoped that patients can choose the treatment method according to the doctor's advice and control the disease in a timely manner.

Clinical manifestations

Some patients with mild to moderate carotid artery stenosis may have no clinical symptoms. Patients who present clinical symptoms related to stenosis are called "symptomatic carotid artery stenosis". The clinical manifestations of symptomatic carotid artery stenosis are mainly related to cerebral ischemia caused by vascular stenosis. According to the time characteristics of onset, it can be divided into transient ischemic attack and stroke. The main difference between the two is whether the patient's ischemic symptoms can be completely relieved within 24 hours. Those that can be completely relieved are transient ischemic attacks, while those that cannot be completely relieved are strokes. The ischemic symptoms caused by carotid artery stenosis mainly include dizziness, memory loss, disorientation, impaired consciousness, amaurosis, numbness and/or weakness on one side of the face and/or limbs, tongue deviation, speech difficulties, and inability to understand what others say.

treat

The treatment of carotid stenosis mainly includes risk factor control, drug therapy, surgical treatment and interventional treatment.

Control of risk factors Atherosclerotic carotid artery stenosis is often part of systemic vascular disease. Therefore, controlling the risk factors that can lead to vascular atherosclerosis is the basis for the treatment of carotid artery stenosis. It mainly includes: proper exercise, weight control, avoiding obesity, quitting smoking, drinking less, and reasonable control of blood pressure, blood sugar, blood lipids, etc.

Drug treatment mainly includes stabilizing atherosclerotic plaques and anti-platelet aggregation drugs. Commonly used drugs in clinical practice are statins, lipid-lowering drugs, aspirin and/or clopidogrel. In addition, drug treatment also includes drug treatment for risk factors such as hypertension and diabetes. Drug therapy can only stabilize atherosclerotic plaques, minimize thrombosis, and slow the progression of atherosclerosis, thereby reducing the occurrence of cerebral ischemic events. It cannot fundamentally remove plaques or restore blood flow to brain tissue.

Surgical treatment Surgical treatment mainly refers to carotid endarterectomy (CEA). It is currently the only method that can remove atherosclerotic plaques and restore normal lumen and blood flow. By the 1980s, many centers in Europe and the United States began to conduct systematic research on CEA. A number of multicenter large-sample randomized controlled studies have shown that CEA is significantly better than drug therapy in treating severe carotid stenosis and symptomatic moderate carotid stenosis. Now, CEA can reach 170,000 per year in North America, and has become the first choice for treating carotid stenosis. It is the "gold standard" for the treatment of cervical carotid artery stenosis.