Carotid Stenosis

Epidemiology

Nearly 50% of men aged over 75 suffer from carotid stenosis, which is the cause of approximately 20% of strokes. It manifests in patients affected by obliterative atherosclerosis of the lower limbs (15% to 30%) or coronary heart disease (5%).

Mecanism

Found in the neck, carotid arteries transfer blood from the heart to the brain. When they are affected by atherosclerosis, a shrinking of said arteries, called stenosis, may occur, which leads to risks that small fragments could detach and make their way to the brain, thereby causing a stroke. The risk of neurological complications increases with the stenosis’ severity. Atherosclerosis mains risk factors include hypertension, diabetes, high cholesterol and tobacco use.

It bears mentioning that a stroke can also be caused by carotid occlusion (thrombosis), depending on blood flow quality through other arteries.

Diagnostic

Carotid stenosis may be completely asymptomatic, meaning that it can only be detected through neck auscultation during a physical examination. Otherwise, diagnosis is made using Doppler ultrasonography (Duplex), a non-invasive exam that enables to determine the presence of atherosclerosis and stenosis severity.

Carotid stenosis may also be diagnosed upon manifestation of temporary or permanent neurological symptoms, such as loss of vision, often in only one eye, loss of speech, or partial paralysis of the face, an arm or a leg. It’s worth noting that the brain’s right hemisphere controls the left side of the body, while the left hemisphere controls the right side.

In any case, an emergency examination of the patient’s health must be done. The diagnosis shall be made through Doppler ultrasonography (Duplex), occasionally confirmed with an angio-MRI or CT Scan, should surgery be considered.

When to intervene

Treatment will depend on stenosis and symptom severity.

Pierre Larose Clinic enables to quickly screen for and diagnose carotid stenosis. Should hospital treatment be required, it could be completed more rapidly.