Carotid stenosis refers to the narrowing of the carotid arteries, major blood vessels in the neck that supply blood to the brain. This condition increases the risk of stroke as it restricts blood flow to the brain. The primary goal of treatment for carotid stenosis is to prevent stroke by managing and reducing the risk of plaque rupture or embolization.
Medical management is often the initial approach for mild to moderate carotid stenosis. This may involve lifestyle modifications, such as adopting a heart-healthy diet, exercising regularly, and quitting smoking. Medications, including antiplatelet agents like aspirin or clopidogrel, and statins to control cholesterol levels, may be prescribed to reduce the risk of blood clots and plaque formation.
For more severe cases of carotid stenosis, particularly when there is a high risk of stroke, invasive interventions may be considered. Carotid endarterectomy (CEA) is a surgical procedure in which the surgeon removes the plaque from the carotid artery, restoring normal blood flow. This procedure is often recommended for individuals with symptomatic carotid stenosis, especially if they have had a recent transient ischemic attack (TIA) or stroke.
Carotid angioplasty and stenting (CAS) is another intervention that involves the placement of a stent to widen the narrowed carotid artery and improve blood flow. This less invasive procedure is performed during a cerebral angiogram and is an alternative to carotid endarterectomy.
The choice between carotid endarterectomy and carotid angioplasty with stenting depends on various factors, including the patient’s overall health, the severity and location of the stenosis, and the presence of other medical conditions. Both procedures aim to reduce the risk of stroke by preventing the embolization of plaque or blood clots from the carotid artery to the brain. After a thorough discussion with your neurosurgeon, the risks and benefits of both these procedures will be detailed to help determine the most appropriate treatment options.
Post-procedural care involves close monitoring to assess the effectiveness of the intervention and to detect any potential complications. Ongoing medical management, including the use of antiplatelet medications and statins, is typically continued to maintain vascular health and reduce the risk of future events.
Individuals with carotid stenosis require a personalized and multidisciplinary approach to care. Prevention and long-term management remain crucial aspects of the overall treatment plan to reduce the risk of stroke and improve the patient’s quality of life. Coaxial Neurosurgical Specialists continues to provide the best contemporary medical and surgical options for patients with carotid stenosis.