Changes often occur inside the blood vessels as a result of nitcotine abuse, long-term diabetes (diabetes) or diet-related changes. Over time, such deposits on and changes to the walls of the blood vessels narrow them further and further, leading to arteriosclerosis and so-called arterial stenosis ("narrowing of the arteries").
The result: circulatory disorders, e.g. in the brain or kidneys, as well as an increased risk of heart attack.
Changes often occur inside the blood vessels as a result of nitcotine abuse, long-term diabetes (diabetes) or diet-related changes. Over time, such deposits on and changes to the walls of the blood vessels narrow them further and further, leading to arteriosclerosis and so-called arterial stenosis ("narrowing of the arteries").
The result: circulatory disorders, e.g. in the brain or kidneys, as well as an increased risk of heart attack.
Stenosis generally describes the narrowing of a blood vessel; arterial stenosis is therefore the narrowing of an artery. In large vessels in particular, a slowly progressing narrowing can remain asymptomatic for a long time. In contrast, smaller arteries, such as those in the brain or kidneys, are affected by stenosis much more quickly.
Arterial stenosis © pankajstock123 #63446706 | AdobeStock
The main cause of stenosis is arteriosclerosis, also known colloquially as hardening of the arteries. Deposits of cholesterol, fatty acids and calcium lead to hardening and increased thickness of the affected blood vessels. The artery becomes increasingly constricted and loses elasticity.
According to current knowledge, the mainrisk factors for arteriosclerotic vascular changes are
Genetic influences also appear to play a role.
As already mentioned at the beginning, larger vessels with a wider cross-section in particular can remain asymptomatic for a long time despite developing arterial stenosis, as is the case with aortic stenosis, for example.
In the case of the often very fine arteries and capillaries in the kidneys and brain, on the other hand, the vessel can become completely blocked relatively quickly - in the kidneys this is known as a renal infarction, in the brain it is a stroke.
The symptoms therefore depend primarily on which artery is affected by a narrowing.
Arterial stenosis in the kidneys is mainly noticed indirectly through high blood pressure that is resistant to treatment. The levels of urinary substances in the blood also rise. Heart palpitations and headaches also occur. Depending on the severity of the arterial stenosis, the brain may also show various symptoms, such as paralysis, speech, visual or sensory disturbances. In severe cases, arterial stenosis in the brain can even lead to coma or even death.
The simplest method is auscultation (listening with a stethoscope) of the kidneys, during which the flow noises caused by turbulence in the affected arteries can be heard.
Doctors use various imaging techniques to reliably detect or rule out arterial stenosis.
Doppler ultrasound (duplex sonography) is also used to visualize the flow conditions in the renal vessels, for example. In the kidneys and brain, it is also possible to use CT(computed tomography) or MRI(magnetic resonance imaging) angiography to visualize the smallest arteries in order to precisely localize constrictions (stenoses). This is important in order to plan further treatment on the basis of the imaging.
In the area of the renal arteries, drug treatment can be attempted in the case of arterial stenosis, particularly for high blood pressure. However, depending on the degree of occlusion of the affected blood vessel, invasive therapy - surgery - will usually follow.
Doctors distinguish between two different surgical approaches:
One is percutaneous transluminal angioplasty, in which a stent is inserted into the narrowed vessel during the procedure. A stent is a thin wire mesh that stabilizes the constriction in the artery and keeps it open. If the vessel is narrowed by more than 60%, doctors generally favor stent surgery.
On the other hand, it is also possible to bypass the narrowed vessel. In medical terms, this is known as a bypass operation. However, this is increasingly being postponed in favor of stenting and is now only rarely performed.
In the case of arterial stenosis in the brain, a stent is inserted in a similar way.
Stenting can now be performed safely and successfully. As a rule, the procedure removes the narrowing in 95% of patients, e.g. in the renal artery. In every second patient, high blood pressure also falls after the arterial stenosis has been removed.
Arterial stenosis and treatment with a stent © crevis #89836026 | AdobeStock
If arterial stenosis is genetic, i.e. inherited, there is nothing that can be done to prevent it.
However, the risk of arteriosclerosis, which is usually the cause of arterial stenosis, can be effectively reduced by adopting a healthy lifestyle and avoiding stress.
Arterial stenosis is one of the vascular diseases for which specialists in vascular and cardiac medicine - angiologists and cardiologists - are particularly responsible. You can find suitable centers and doctors in your area under the following link.
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