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Diseases of carotid arteries
June 8, 2012
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Carotid arteries are arteries on which there is a blood supply of bodies of the head and neck. On them there passes the blood stream to a brain of the person. Carotid arteries depart in a thorax from an aorta, then pass through a neck in a skull and reach a brain.
Atherosclerosis of carotid arteries
As a rule, atherosclerosis of carotid arteries occurs how this disease affects arteries of other pools. The stenosis of a carotid artery, that is its obstruction, arises as an emergence effect in an artery of an atherosclerotic plaque. Pathologists reduction and deterioration in a blood-groove up to an artery becomes result such. The artherothrombosis and a stroke of a brain can become a result of this phenomenon. Than the person is more senior, especially the risk of development of defeat at it atherosclerosis of carotid arteries is high. So, in group of people, is more senior than eighty years the stenosis of a carotid artery is shown at 10% of people.
At a normality the wall of arteries has to be smooth. However when progressing atherosclerosis owing to emergence of plaques in walls of carotid arteries their gleam considerably decreases. Such plaques form from deposits of cholesterol, fibers of connecting fabric, a number of lipid fractions. Than more plaques increase, and their quantity increases, especially expressed there is a narrowing of a gleam of a vessel. In process of progressing of atherosclerosis there is more and more expressed disturbance of supply with brain blood. As a result atherosclerosis of carotid arteries – an illness which is very serious and dangerous is diagnosed for the person. Its development is fraught with serious violations of blood circulation of a brain and a stroke.
Sometimes in vessels soft atherosclerotic plaques in which there are cracks and gaps later are formed. Roughness of a surface of a plaque is perceived by a human body as defeat, and as a result of an inflammation blood clot develops. If in a carotid artery there is big blood clot, then blood supply of a brain can be broken very seriously, and sometimes and to stop completely. As a result the person has a stroke. Sometimes there is other development of a disease: the plaque and blood clot are divided into fragments and migrate with a blood-groove. In the course of movement of these particles there is an obstruction of small arteries that similarly conducts to a stroke.
Symptoms of atherosclerosis of carotid arteries
In view of the fact that atherosclerosis of carotid arteries at the first stages of development generally does not provoke manifestation of noticeable symptoms, in most cases the stroke becomes the first symptom of defeat by atherosclerosis of carotid arteries. But nevertheless at the attentive relation to a condition of own organism of people can note some signs preceding development of a stroke. They are called tranzitorny ischemic attacks. The symptoms characteristic of this state, as a rule, can proceed no more than an hour. At similar attacks of the patient feels strong weakness, a condition of catalepsy. In one half of a body he can feel an itch, a pricking. Often similar manifestations arise in a leg or a hand. For the period of such attack of people can lose control over an extremity, sight sometimes vanishes in one eye, the speech becomes inarticulate. As a rule, signs of tranzitorny ischemic attack completely disappear in a day. But manifestation of such "signal" cannot be ignored at all as it is a sign that soon the person will have a stroke. Therefore it is extremely important to address at once the specialist and to pass full inspection.
Atherosclerosis of carotid arteries develops similar to atherosclerosis of other arteries. More rare, in certain cases aneurism of a carotid artery is the reason of this state. The probability of development of atherosclerosis of carotid arteries and at patients with a diabetes mellitus increases.
Aneurism of carotid arteries
Aneurism of vessels of a brain is a life-threatening standing which becomes frequent the reason of hemorrhages in a skull with death. Aneurism of a carotid artery is a diffusion or limited expansion of a gleam of an artery or existence protrusion of a wall of an artery. The wall of aneurism consists of the cicatricial connecting fabric having different thickness. And in her cavity sometimes there are clots having different prescription of an origin. In carotid arteries of aneurism arise most often. Aneurisms happen both multiple, and single.
The reasons of their education are up to the end not established. In certain cases developing of this pathology is provoked by the infected emboluses which get into a brain. A number of aneurisms of other types arises owing to the changes happening under the influence of atherosclerosis. Also inborn inferiority of arteries of a brain, a hypertension, injuries is the reasons of emergence of aneurisms.
Arterial aneurisms are shown in an apoplectic and opukholepodobny form. The apoplectic form at which hemorrhage arises suddenly, without preliminary symptoms is more often diagnosed. This form is characterized by sudden development of subarachnoidal hemorrhage. In rare instances before hemorrhage of the person morbidity in frontal and orbital area disturbs, paresis of cranial nerves is shown.
The sharp headache which is shown suddenly becomes the main symptom of a rupture of aneurism always. Initially it arises in the specific place, becomes diffusion later. In the course of progressing of pain at the patient vomiting, nausea is shown, he can faint for a long time. Emergence of disturbances of mental character is possible. If bleeding occurs in cerebral cavities, then the illness proceeds extremely hard and comes to an end with a lethal outcome.
Aneurisms of an internal carotid artery can be divided into several groups depending on their arrangement: aneurisms in a cavernous sine, aneurisms near bifurcation of a carotid artery, aneurism of supraklinoidny part of an artery.
At a rupture of aneurism it is important to observe a high bed rest within six-eight weeks. Today the radical method of treatment of aneurism consists in carrying out a surgery for the purpose of cliping of a neck of aneurism. There are also new techniques of surgical treatment of aneurisms which are successfully put into practice.
Diagnosis of diseases of carotid arteries
To diagnose diseases of carotid arteries, the doctor surely conducts detailed survey of the patient with the purpose to learn about all shown symptoms, history of an illness and features of health of the patient. In this case data on smoking of the patient, and also on features of his arterial pressure are considered as the most important information. After that the doctor performs inspection of the patient. Auscultation of carotid arteries for detection of vortex current is without fail carried out. It demonstrates existence of narrowings. At statement of the diagnosis measurement of arterial pressure is surely taken.
Informative method in the course of diagnosis of a disease of carotid arteries Doppler ultrasonic research of carotid arteries is considered. Ultrasonography allows to give an adequate assessment to structure of a vessel and a blood-groove in it. As a rule, carrying out such research allows to define existence of a disease of carotid arteries precisely. In more exceptional cases additional information which can be received during the carrying out a computer tomography, the KT-angiography is necessary for the doctor for establishment of the exact diagnosis.
The method of an angiography is based on use of administration of contrast medium and use of x-ray emission. Such technique allows to receive as a result especially exact image of arteries and to consider all changes which happened in them. However such research is fraught with existence of risk of an injury of an atherosclerotic plaque and, as a result, manifestation of tranzitorny ischemic attack or a stroke. Therefore such research is appointed seldom.
Treatment of a disease of carotid arteries
Treatment of a carotid artery directly depends on that, the stenosis of a carotid artery, what severity of defeat is how expressed by atherosclerosis. Also the doctor surely pays attention to symptoms of a disease and the general condition of the patient. If in the course of diagnosis at the person atherosclerotic defeats of carotid arteries were revealed, then it is extremely important to patient to change immediately way of life, being guided by recommendations of the doctor, and it is obligatory to receive medical treatment for medicamentous drugs.
Patients with a diabetes mellitus have to inform of it the attending physician surely. The people having arterial hypertension have to accept drugs for normalization of arterial pressure. Surely it is necessary to stop smoking, to keep to a diet, using products with the low content of cholesterol. Sometimes treatment by statines – drugs which reduce cholesterol level in blood will be reasonable.
In case of severe defeats atherosclerosis of carotid arteries carrying out surgical treatment is reasonable. In the course of such operation the atherosclerotic plaque is removed, and the gleam of a vessel is recovered. The attending physician makes the decision on what method of surgical therapy to choose in each case. Today two surgical techniques are actively applied to treatment of atherosclerotic defeats of carotid arteries. It is an endarterectomy method, and also balloon angioplasty and stenting.
Carrying out endarterectomy happens to local or general anesthesia. The section for removal of an atherosclerotic plaque becomes rather small.
If extended defeat of a carotid artery atherosclerosis takes place, then carrying out prosthetics of an internal carotid artery is possible. Thus, the blood stream is started on a prosthesis — an artificial vessel.
In the presence of pathological crimpiness of a carotid artery straightening of an artery, and removal of its changed part is made.
Carrying out angioplasty and stenting demands only local anesthesia. In inguinal area the puncture through which enter a catheter to that place where the carotid artery was damaged into a femoral artery is made. On it also deliver the necessary devices for performance of angioplasty and stenting. In certain cases after carrying out procedure for fixing of a gleam of a vessel carry out implantation of a stent. The treatment method is also chosen and depending on that, narrowing of a gleam of a carotid artery is localized where exactly.
The patient whom diagnosed defeat of carotid arteries atherosclerosis, but priety the doctor considers carrying out operation inexpedient, it is necessary to adhere to all recommendations of the specialist very strictly. Conservative therapy of atherosclerosis assumes full refusal of smoking, providing daily exercise stresses, drug treatment with the ordered drugs, regular tracking of level of arterial pressure, sugar of blood, cholesterol. In the course of treatment sick most often appoint aspirin and statines.
If a disease of carotid arteries not to treat timely, then the stenosis of carotid arteries will accrue, the patient will suffer from the all-brain symptoms which are shown constant dizzinesses and headaches. And the lethal outcome can turn out to be consequence of an acute disorder of cerebral circulation.
Prevention of a disease of carotid arteries
Prevention of diseases of carotid arteries allows not only to prevent display of atherosclerosis, but also to slow down its progress in a case of the beginning of development of an illness. As the main measures of prevention it should be noted obligatory and full refusal of smoking, an opportunity to daily carry out physical exercises, to keep to the correct diet. The person has to watch closely a body weight as people with obesity are included into risk group of development of atherosclerosis of carotid arteries.
Observance of measures of prevention and is very important for people with atherosclerosis who already underwent an operation. After an operative measure continuation of therapy of the main illness, and also acceptance of all measures is important in order that the illness did not progress. Therefore the recommendations stated above are not less actual and in this case. However people who underwent an operation should show consideration for all measures of prevention extremely. So, refusing smoking, it is necessary to protect itself and from passive inhalation of a smoke which does not less serious harm to an organism. It is necessary to take all measures to lose extra kilos even if it is a little of those. It is proved that, losing about five kilograms of excess weight, the person provides considerable decrease in level of sugar and cholesterol in blood. Therefore, such changes allow to reduce doses of the accepted medicines as a result noticeably.
To the people having atherosclerosis of carotid arteries, doctors advise special attention to pay on food. It is important to eat not to exchange of four times a day, at the same time the supper is not welcomed. In breaks between meals it is not necessary to have a bite harmful products: it is the best of all to be limited to fresh vegetables and fruit. It is very useful to arrange once in two weeks a fasting day, eating for this day only one type of products – kefir, apples, a water-melon, etc. The diet has to contain the minimum quantity of fat products, and also easily assimilable carbohydrates. Also decrease in the consumed cholesterol and, as a result, its removal from an organism will be a consequence of the correct approach to food.
During the postoperative period administration of drugs which do blood of more liquid is shown to patients. In this case small doses of aspirin are often appointed. Such measure of prevention will help to prevent emergence of blood clots.
It is impossible to allow hypodynamias at all: exercise stresses will help to keep the level of sugar, cholesterol, and also indicators of arterial pressure under control. However it is necessary to treat performance of any exercises carefully, stopping training at the first boards of a stethalgia, asthma, other unpleasant feelings.
Treatment of an arterial hypertension – one more important measure of prevention directly influencing a condition of carotid arteries.
To avoid a repeated operative measure, it is regularly necessary to pass the researches appointed by the attending physician and to monitor all changes in the operated vessels. Timely detection of problems considerably will facilitate their treatment.
Section: Diseases of vessels