- Carotid artery diseases (narrowing of the jugular veins)
Carotid vascular disease runs from both sides of the neck, enters the skull and feeds both hemispheres of the brain. It is a disease that occurs as a result of narrowing or occlusion of the responsible carotid arteries.
- What are the causes of the disease?
It has been shown that there are various factors. Generally accepted as Hypertension, Nicotine addiction, Diabetes, high blood lipids and Genetic factors
- What are the symptoms?
Loss of strength in the arm and/or leg on the opposite side of the affected carotid artery, loss of sensation, loss of movement, temporary or permanent visual impairment on the same side, fainting, loss of consciousness, facial paralysis and speech disorders.
- What is a stroke?
When the circulation to a part of the brain is interrupted for more than a few minutes, the brain cells in that area are destroyed and the patient develops loss of vision, speech, movement or sensation in certain parts of the body. If the underlying disease state is temporary, the symptoms it causes may also be temporary and this situation is called “Transient ischemic attack”.
- Are there different types?
Asymptomatic carotid artery stenosis; Carotid artery stenoses detected by stethoscope auscultation or incidentally on Doppler sonography
Symptomatic, that is, temporary or permanent loss of movement and sensation lasting less than 48 hours, speech disorder, hand, arm or loss of strength in the leg
- What are the examination and examination methods?
Various methods can be used in clinical examination.
- Is treatment possible? If so, are the options? What are they?
Medical treatment, surgical treatment and interventional radiological interventions
Medical Treatment Treatment of concomitant diseases with risk management, blood thinner treatment, vasodilator drugs It is done by giving.
Med. gentle treatments; These are treatments applied only to veins whose carotid artery is narrowed but not completely blocked. There is no need to apply any interventional treatment to the clogged carotid artery.
A – Surgical treatment; ranks first among non-cardiac vascular operations in the world. With nearly half a century of experience, it is all over the world. In the treatment of symptomatic (with symptoms of complaint) and partially asymptomatic (without symptoms)carotid artery patients with a low complication rate (2 – 5%) It is the method accepted as the gold standard. Surgical treatment consists of removing the plaque causing the stenosis under general, regional or local anesthesia and, if necessary, widening the narrowed carotid vessel by applying a patch and directly closing it if it has a sufficient diameter.
- Operation and post-operative period. How does it work?
In our clinic, this operation is performed with regional anesthesia, that is, without anesthesia, while the patient is conscious, and patients can be discharged home on the 2nd day after the operation. The main advantage of this method is that since the patient is conscious during the operation, it provides the opportunity to intervene quickly in any problems that may arise at that moment. In general anesthesia, it is possible to do this only when the patient recovers from the effects of anesthesia and wakes up.
Situations requiring surgery; Patients who have had transient attacks are primarily indicated for an operation. It has been observed that the risk of stroke in this group of unoperated patients is on average 20% within 5 years. In patients who do not show asymptomatic symptoms, an operation is indicated in the following cases.
Bilateral severe stenosis (> 90%)or unilateral stenosis with total occlusion of the opposite side
Medical Stenosis > 80%, which are progressive despite treatment surgery)
Interventional radiological treatments; Balloon Angioplasty + Stent implantation method has been used successfully for many years in narrowing of the vessels in various parts of the body. The stent method has been used for a short time in neck vein occlusions. Due to reasons such as the fact that the short-term results of this method, which has been applied in this region in recent years, have not shown any superiority over surgery, and the long-term results are still unknown, this method is only applied to a selected group of patients and especially in cases where the operation cannot be performed due to technical and other reasons.
Balloon angioplasty + Stent implantation is applied to selected symptomatic patients (who show signs of disease and have complaints related to it).
As indications;
- Patients who have received radiotherapy in the neck area,
- Patients where the stenosis remains in the skull that is difficult to reach for surgery during angiography,
- Recurrent stenosis that develops in the long term after the operation
- There is no place for treatment in asymptomatic patients without complaints, except for the above cases.
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