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Carotid stenosis

Mechanism, diagnosis and risk factors

What is carotid stenosis?

Carotid stenosis is characterized by a narrowing carotid artery, affected by cardiovascular risk factors such as smoking, alcohol, high cholesterol, high blood pressure and diabetes.

These risk factors encourage plaque deposits on artery walls and can lead to serious consequences, such as a stroke.

Who is
at risk?

Nearly 50% of men over age 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%).

How does it form?

Located in the neck, carotid arteries transfer blood from the heart to the brain. When they are affected by atherosclerosis, arteries can narrow (a process called stenosis), increasing the risk of small fragments detaching and making their way to the brain, thereby causing a stroke.

Risk of neurological complications increases with stenosis severity. Atherosclerosis’s main risk factors include hypertension, diabetes, high cholesterol and tobacco use.

A stroke can also be caused by carotid occlusion (thrombosis), depending on quality of blood flow circulating in other arteries.

We can make the right diagnosis.

How is it diagnosed?

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 a Doppler ultrasound (Duplex), a non-invasive exam that enables determination of the presence of atherosclerosis and stenosis severity.

Carotid stenosis may also be diagnosed once temporary or permanent neurological symptoms appear, 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, emergency assessment of the patient’s condition must be done. The diagnosis will be made using a Doppler ultrasound (Duplex), and occasionally confirmed with an angio-MRI or CT Scan, should surgery be considered.

Costs for Doppler ultrasounds performed at Clinique Pierre Larose are not covered by the Régie de l’assurance-maladie du Québec (RAMQ). However, many private insurance providers will cover them.

to intervene?

Treatment will depend on severity of stenosis and symptoms. Clinique Pierre Larose makes it possible to quickly screen for and diagnose a carotid stenosis.

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