Treatment of carotid stenosis: Medications, lifestyle and surgery

Author:
Bc. Lukáš Tóth
Bc. Lukáš Tóth
Healthcare worker

The role of treatment is to improve blood flow through the carotid artery. 

The indication for surgical treatment is mainly for carotid stenosis above 70%. In that case, carotid endarterectomy is chosen.

It is the removal of atherosclerotic plaque. And this is done by classical surgery of the vessels of the neck.

Clamps are placed below and above the area of damage and the blood flow through the affected section of the artery is stopped. 

Blood flow through the brain is provided by the rest of the Circle of Willis.

The procedure is performed under local anaesthesia. This allows control of neurological functions (consciousness, speech, limb movement - squeezing the ball) during the operation.

If temporary restriction of flow through the artery is not tolerated, it is necessary to create a temporary shunt - a vascular shortcut and bypass the damaged vessel.

However, this method is not suitable for everyone.

Learn more about stroke patient management.

There are several contraindications for which it is not performed, such as an excessively high age over 80 years and the association of multiple, mainly, cardiac diseases and in unstable patients.

A less invasive form is the endovascular method, hence angioplasty - carotid stenting. It also aims to restore normal blood flow through the carotid artery.

Abbreviations:
CEA - Carotid endarterectomy, 
CAS - carotid stenting. 

Urgency assessment:

  1. emergent - performance in minutes to hours
  2. urgent - within 48 to 72 hours
  3. required within 14 days
  4. optional/elective - performance within 4 to 6 weeks - delayed

Pharmacological treatment is important.

It includes:

  • medicines to maintain normal blood pressure - antihypertensives
  • anti-clotting drugs - antiplatelet agents and anticoagulants
  • thorough treatment of diabetes
  • medicines for high cholesterol

Also, prevention and lifestyle change are of high importance. 

Regimen measures and lifestyle change are based on:

  • modification of eating habits
  • a rational diet, intake of sufficient fibre, fruit and vegetables
  • reducing salt and fat intake
  • non-smoker
  • alcohol restriction
  • sufficient physical activity
  • limitations of a sedentary lifestyle
  • reducing overweight and obesity and maintaining an appropriate body weight
  • blood pressure and pulse monitoring
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Bc. Lukáš Tóth
Bc. Lukáš Tóth
Healthcare worker
The secondary medical school in Nitra gave me the basis for my career in the field of health and diseases. Thanks to it, I worked for 2 years in the traumatology clinic and outpatient clinic at the Nitra Hospital. Since 2006 I was employed in the emergency medical service, where I stayed until 2017. I completed my bachelor's degree at the University of Constantine the Philosopher in Nitra in the field of emergency health care. The bachelor's degree allowed me to continue my mission as a paramedic. In the meantime, I got a job at the emergency line 155. I have been working in pre-hospital health care until today. I had an interest in people, health and even diseases in my childhood, which gave me the prerequisite to pursue this topic in adulthood. Studying and acquiring new information in practice provided me with a great basis for writing professional texts, in the form of articles that can be understood by ordinary people. Thus, my interest in the Health Portal has a solid foundation in years of practice and personal interest. Similarly, I am also interested in healthy eating, nutrition and overall healthy lifestyle. I fill my free time with family and sports.
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