(narrowing of the carotid artery)
A narrowing of the internal carotid artery is usually caused by age-related calcium deposits, which are promoted by risk factors such as smoking, high cholesterol, diabetes and high blood pressure.
Symptoms
A narrowing of the internal carotid artery is often discovered by chance during an ultrasound examination, without any symptoms being noticed.
Severe narrowing of the internal carotid artery can impair blood flow to the brain. This often manifests itself in sudden, short-term visual disturbances, speech disorders, sensory disturbances and paralyses of the arms or legs.
In addition, parts of the calcium deposits or blood clots that have formed on them can become detached and be carried into the brain, where they can lead to a blockage of the vessels and ultimately cause a stroke.
Diagnostics
Narrowing of the internal carotid artery can be diagnosed and checked very easily by means of an ultrasound examination of the neck vessels.
In some cases, further diagnostics using computer tomography with contrast medium (CT angiography) and/or magnetic resonance imaging of the head (cMRI) are necessary.
Therapy
In the case of an incipient mild narrowing of the internal carotid artery, it is initially sufficient to reduce the risk factors (nicotine cessation, blood pressure control, diabetes control) and to take an antiplatelet agent (e.g. ASA 100 mg/d) and a cholesterol-lowering drug (statin).
If there is a pronounced narrowing of the internal carotid artery without symptoms, surgical treatment is recommended to prevent a stroke.
In the case of a narrowing of the internal carotid artery with new symptoms or a stroke, surgery should be performed promptly if appropriate.
There are generally two treatment options available. Both methods aim to reduce the risk of a stroke in patients with narrowing of the internal carotid artery. Which method is suitable in each individual case must be decided on a case-by-case basis.
Open surgery is performed under general anaesthetic. During the procedure, the carotid artery is exposed via an incision in the neck and the calcification is then peeled out (thrombendarterectomy). A small patch of tissue ("patchplasty") is then sewn in. The inpatient stay is usually only a few days. Before discharge, the results are checked using ultrasound.
In minimally invasive (endovascular) therapy, which involves dilating the narrowing with a balloon and inserting a stent, the patient is given a local anaesthetic. The narrowed area is then first dilated with a balloon via the inguinal artery and then a stent is inserted to keep the vessel open. The inpatient stay is usually only a few days.
