carotid artery occlusion

First of all, it is necessary to briefly talk about the blood circulation of the brain. The brain and heart are independent of general circulation rules. This is because they are both vital organs and for the purpose of protecting them. Both organs independently determine their own circulation. They are protected as much as possible from conditions such as low blood pressure in the body and the effects of the sympathetic nervous system that provides control.

Cerebral circulation is provided by two anterior (right and left) carotid arteries (carotid) and posteriorly by two vertebral vessels (vertebral artery). When the blood flow (stenosis or occlusion) decreases in one of these four main vessels by hearing from each other, the others increase the flow and provide adequate circulation.

The four vessels form a circulatory network that begins at the base of the brain. This network is called the Willis Polygon.

Carotid veins are affected by atherosclerosis called arteriosclerosis or vascular calcification disease like general arteries. As a result, there may be narrowing of the carotid artery and complete occlusion in the future. Pieces of these calcified vessels break off and prevent blood flow to some areas of the brain and destroy the brain’s function. Depending on this, various symptoms occur, especially paralysis.

There may not be a symptom in carotid artery occlusion, but if there is a symptom, roughly paralysis-like symptoms are seen. Partial paralysis (facial paralysis), vision loss, speech disorder, numbness in the hands and arms, loss of power can be seen, which causes effacement at the lip edge.

You can access the articles and videos I have prepared on this subject in the Vascular Diseases section.

Even if all these symptoms are seen for the first time, they can occur with a complete paralysis picture. Since the picture of paralysis occurs, the picture can be punctuated by partial loss of strength, permanent speech or immobility in the limbs, sometimes with severe brain damage that can be life-threatening. Since such a situation creates a very distressing situation for the patient and their relatives, it is a disease that is always feared.

DIAGNOSIS OF CAUDAR OCCLUSION

• Stenosis in the carotid artery is suspected in the first stage when a murmur (abnormal sound of blood passing through the narrowed area) is heard during examination.
• The first examination is the Neck Vascular Ultrasound. With this examination, both the jugular vein and the posterior veins of honor are evaluated.
• If stenosis is detected in the Carotid Veins, this is expressed as a percentage. 100% stenosis means that the vessel is completely occluded and no blood can pass through it. Complete blockage can happen slowly and without symptoms. Sometimes, sudden complete blockage can also create a severe paralysis picture that causes loss of function of the entire cerebral hemisphere. With deep coma and permanent brain damage, the patient may enter a vegetative state.
• As an advanced examination, Classical Angiography, DSA (a special angiography), Computed Tomographic Angiography or MR Angiography can be performed.
• Since such patients may have concomitant Cardiovascular Occlusion, they should also be examined in terms of the heart. Heart Coronary Angiography can often be done at the same time.
• After the diagnosis is finalized, a decision is made by the council made by Neurology, Cardiology and Cardiovascular Surgery.
• Diffusion brain MRI may be performed to evaluate low-grade stenosis. The purpose of this examination is to see if small pieces of the vessel go to the brain and cause minor damage. The result of this examination is effective in deciding whether to intervene in the Carotid Vein.
• If there is a stenosis of 70% or more; The patient is recommended surgery. In lower grade and simple stenosis, stent can be inserted interventionally.
• If some patients are diagnosed when they apply to the hospital with permanently damaged paralysis, surgery or intervention is not performed. It is appropriate for the patient to be operated after 3 months of treatment.

• If the carotid artery is 100% occluded, surgery is not performed. If stenosis or occlusion in the fine capillaries in the brain is detected in one of the patients, only drug treatment is recommended for these patients. Alternative treatment methods can be applied to these patients.

JUDGMENT SURGERY

In carotid endarterectomy, carotid artery surgery, the narrowing plaque is removed under general anesthesia and a patch is applied on the opened place. Thus, both blood flow is ensured and the possibility of small parts to go to the brain is eliminated.

Can carotid artery occlusion be operated without complaints or symptoms?

If the narrowing progresses slowly, the obstruction does not give any symptoms. Patients continue their normal lives. If diagnosed incidentally, the risk of stroke should be assessed as described above.

If the patient will have open heart surgery, the carotid artery is checked in the preparatory examinations. If this type of patient has 70% or more stenosis of the carotid artery, the risk of stroke is very high during open heart surgery. These patients should have simultaneous or progressive carotid artery and bypass surgery.

WHAT IS THE RISK OF JUDGMENT SURGERY?

IS THERE A RISK OF PALACE?

This surgery is widely performed around the world. We have important data at our disposal.

If patients have signs of stenosis, surgery is recommended when they are at risk of paralysis. If there are no symptoms, surgery is decided because the risk of paralysis without surgery is higher than the risk of paralysis in surgery.

Roughly, there is a 1-3% risk of stroke in carotid artery surgery, this is an event that depends on the experience of the hospital and the surgeon. The faster it is done, the better.

In the stent procedure, the parts are prevented from going to the brain with a protective filter.

After the carotid artery surgery, 150 mg/day Aspirin or another blood thinner is given together. Today, dual blood thinners and new drugs are used.

In addition to these drugs, cholesterol and blood pressure drugs are also used when necessary.

It is recommended to control the operation with ultrasonography once a year.

VIDEO 10 SYMPTOMS OF PALACE

VIDEO: WHAT IS A STROKE?

Key

Carotid artery surgery, stroke, risk of stroke, serdar akgün

Health, heart, cardiovascular, vascular occlusion