Carotid artery ㅣ Source: Hidak
The carotid artery is a large blood vessel that branches off from the aorta from the heart. Of the blood pumped from the heart, 80% of the blood to the brain passes through the carotid artery. The carotid artery is divided into the internal carotid artery and the external carotid artery, which supply blood from the common carotid artery to the brain. This is called carotid artery occlusion and stenosis disease.
According to data released by the National Health Insurance Corporation, in 2020 100,000 people were treated for carotid artery occlusion and stenosis. Of these, 60,000 are men and 40,000 are women. This is an increase of 38,000 patients over the number of patients in 2016, with an average annual growth rate of 12.7%.
In 2020, the age group with the highest number of patients was 60, representing 35.3% of the total. Those in their seventies were followed by 30.7%, followed by those in their fifties with 17.2%. The number of patients per 100,000 population was 194.5 in 2020, an increase of 59.3% compared to 2016.
Professor Seo Kwon-duk of the Department of Neurology at National Health Insurance Ilsan Hospital said: “Since smoking acts as a major risk factor for carotid artery occlusion and stenosis, the prevalence is higher among men who they smoke than women “. The following is what Professor Seo Kwon-duk explained about carotid artery disease.
Causes of carotid artery stenosis
As carotid artery stenosis progresses due to atherosclerosis, factors that can cause atherosclerosis can be the cause of carotid artery stenosis. Atherosclerosis progresses slowly with age, but can progress more rapidly in the presence of diseases such as hypertension, diabetes and dyslipidemia (hyperlipidemia). Smoking, excessive alcohol consumption, and obesity are also risk factors for the progression of atherosclerosis.
Main symptoms of carotid artery stenosis
Since the carotid artery is the largest blood vessel that supplies blood to the brain, when the carotid artery narrows, the blood supply to the brain becomes insufficient and various symptoms may appear.
If carotid artery stenosis progresses severely, a brain infarction (ischemic stroke) can occur in which the brain is damaged due to insufficient blood flow. The stage where carotid artery stenosis is not severe is also a problem. Atherosclerosis causes “atherosclerotic plaque”, a lump formed by the accumulation of cholesterol or inflammatory cells in the blood vessel wall within the carotid artery. Atherosclerotic plaques do not disappear once they have formed.
Symptoms of cerebral infarction include paralysis of the face, arm and leg opposite the damaged brain and speech disorders. Also, if carotid artery stenosis becomes severe, blood flow to the eye is insufficient and transient dark vision may appear, a symptom of temporary difficulty seeing the same eye.
Diagnosis and examination techniques for carotid artery stenosis
Stenosis usually occurs where the external and internal carotid arteries diverge. Therefore, a simple method of ultrasound examination of only this area can confirm the disease of the blood vessels. If blood flow velocity has increased more than a certain standard on carotid ultrasound or if large atherosclerotic plaque is present, further tests may be done for accurate assessment. The exact condition can be known by doing computed tomography angiography or magnetic resonance angiography.
2 ways to treat carotid artery stenosis
Carotid endarterectomy and carotid artery stent. The risk of complications within one month of surgery or procedure is known to be lower with carotid endarterectomy than with carotid artery stent. However, there is no significant difference when comparing the long-term prognosis. There are patients who cannot undergo carotid endarterectomy depending on the disease and underlying characteristics, in this case the carotid artery stent is performed.
Prevention of carotid artery stenosis
Since carotid artery stenosis occurs when atherosclerotic plaques caused by arteriosclerosis gradually grow, risk factors for atherosclerosis need to be controlled. Drug treatment for hypertension, diabetes and dyslipidemia (hyperlipidemia), which are controllable risk factors, should be actively carried out. Also, if carotid artery stenosis is confirmed, smoking should be stopped. You need to be careful not to become overweight due to excessive alcohol consumption and lack of exercise.