Carotid stenosis: specialists and information

Carotid stenosis is the narrowing (stenosis) of the carotid artery. It does not always cause symptoms. However, if neurological deficits occur, such as visual disturbances, this can be a precursor to a stroke. The diagnosis is made by ultrasound examination. Treatment can often be carried out with medication if there are no symptoms. However, if symptoms are present, an operation by specialists in vascular surgery is absolutely necessary. The surgical options are stent implantation (stent = vascular support) and open surgical excision of the narrowing.

Below you will find further information and selected carotid stenosis specialists.

In medicine, stenosis is the narrowing of a hollow organ, such as blood vessels or the spinal canal. When the carotid artery (carotid artery) or the outgoing vessels are narrowed, doctors speak of carotid stenosis.

The carotid artery supplies the brain with oxygen-rich blood. Carotid artery stenosis leads to an undersupply of oxygen to the brain - ultimately resulting in a life-threatening stroke.

Carotid stenosis refers to the narrowing of the carotid artery @ songkram /AdobeStock

Causes of carotid artery stenosis

The most common cause of narrowing is arteriosclerosis ("hardening of the arteries"). This means that the inner walls of the vessel gradually become covered with

connective tissue, thrombi (blood clots), blood lipids and/or calcium. These narrow the cross-section of the vessel.

The development of carotid stenosis can be favored by the following factors:

• High blood pressure
• Elevated blood lipid levels
• Smoking and
• Increased age
• Other diseases (e.g. vascular inflammation)

Symptoms and complications of carotid stenosis

The narrowing of the carotid artery can lead to an embolism (blockage of a blood vessel) or a lack of blood flow. This causes a reduced supply of oxygen to the brain.

Carotid artery stenosis can go unnoticed for a long time.

However, it can also lead to neurological deficits, such as

• impaired vision and speech or
• paralysis in the legs and arms

Occasionally, the following symptoms may also occur:

• Double vision
• Severe headaches or
• Dizziness

These symptoms are considered warning signs of an impending stroke, in which the brain is permanently damaged. It is essential that you have the cause of the symptoms medically clarified.

In addition to a stroke, other complications can also occur:

• Transient ischemic attacks (TIA, temporary neurological deficits) and
• Amaurosis fugax (temporary visual impairment)

Diagnosis of carotid stenosis

The symptoms can already provide an initial indication of carotid stenosis. This suspected diagnosis can be confirmed by examining the carotid artery using ultrasound (color-coded Doppler sonography).

Doppler sonography is a painless examination method that measures the speed and direction of blood flow @ Pepermpron /AdobeStock

With this ultrasound examination, the doctor can assess the constrictions in the vessels. It is completely painless and harmless for the patient.

The doctor obtains further information using the following methods:

• Magnetic resonance imaging (MRI ) and
• Computed tomography angiography (CT angiography)

These procedures are often used to plan a suitable therapy.

Treatment of carotid stenosis

There are three options for the treatment of carotid stenosis.

• Drug therapy

The prerequisite for drug treatment of carotid stenosis is that it is not yet causing any symptoms. Drug treatment is intended to reduce risk factors (e.g. high blood pressure) and the risk of complications (e.g. stroke).

• Open surgery

Doctors use open surgery to surgically remove the narrowing of a carotid stenosis. One example is the established carotid thrombendarterectomy.

This is performed byspecialists in vascular surgery. As part of this operation, doctors open the carotid artery and excise the constrictions.

• Stent implantation

Stent implantation is performed endovascularly: the specialists expand the constriction as part of a minimally invasive operation. A balloon catheter is used for this. They then insert a stent (vascular support) to keep the narrowing open.

Which specialists and specialist clinics treat carotid stenosis?

Specialists for carotid stenosis are usually

• Vascular surgeons (specialists in vascular diseases) or
• Neurologists (specialists for diseases of the brain and nerves)

Further examinations are carried out by specialists in radiology or nuclear medicine. Any operations are performed by specialists in vascular surgery.

Facilities specializing in the treatment of carotid stenosis are clinics for vascular surgery or vascular medicine, neurology and angiology.