Cargando…
Carotid Artery Stenosis: A Look Into the Diagnostic and Management Strategies, and Related Complications
Carotid stenosis (CS) is a buildup of atherosclerotic plaque within the artery leading to a wide range of symptoms, from mild symptoms, including blurred vision and confusion, to much more life-threatening presentations, including paralysis due to stroke. The presentation is insidious, with symptoms...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10250083/ https://www.ncbi.nlm.nih.gov/pubmed/37303351 http://dx.doi.org/10.7759/cureus.38794 |
_version_ | 1785055678108270592 |
---|---|
author | Ismail, Aqsa Ravipati, Shivani Gonzalez-Hernandez, Diana Mahmood, Hashim Imran, Alizay Munoz, Eduardo J Naeem, Saad Abdin, Zain U Siddiqui, Humza F |
author_facet | Ismail, Aqsa Ravipati, Shivani Gonzalez-Hernandez, Diana Mahmood, Hashim Imran, Alizay Munoz, Eduardo J Naeem, Saad Abdin, Zain U Siddiqui, Humza F |
author_sort | Ismail, Aqsa |
collection | PubMed |
description | Carotid stenosis (CS) is a buildup of atherosclerotic plaque within the artery leading to a wide range of symptoms, from mild symptoms, including blurred vision and confusion, to much more life-threatening presentations, including paralysis due to stroke. The presentation is insidious, with symptoms exhibiting predominantly at severe stenosis; hence the emphasis is placed on the importance of early diagnosis, treatment, and lifestyle modifications. CS is seen undergoing almost the same pathogenesis of any atherosclerotic plaque formation, from endothelial damage of the artery lumen to the formation of a fibrous cap with a foam cell, lipid-filled core. The findings of our review article were consistent with the recent literature, depicting that comorbid hypertension, diabetes, and chronic kidney disease (CKD), and lifestyle aspects, including smoking and diet, played the most salient role in plaque development. Among several imaging modalities, duplex ultrasound (DUS) imaging is the widely preferred method in clinical practice. Carotid endarterectomy (CEA) and carotid stenting are the primarily advocated procedures for symptomatic severe stenosis, with similar long-term outcomes. Although, earlier clinical trials showed promising results in mitigating the risk of stroke among asymptomatic severe CS with surgical intervention. However, recent advancements have shifted the focus to medical management alone due to comparable results among the asymptomatic population. Both surgical and medical regimens are beneficial in treating patients, but it is still an ongoing debate as to which is predominantly superior. The currently advancing trials and research will help elucidate definitive guidelines. However, the massive impact of lifestyle modifications advocates some degree of individualized multidisciplinary management strategies. |
format | Online Article Text |
id | pubmed-10250083 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-102500832023-06-09 Carotid Artery Stenosis: A Look Into the Diagnostic and Management Strategies, and Related Complications Ismail, Aqsa Ravipati, Shivani Gonzalez-Hernandez, Diana Mahmood, Hashim Imran, Alizay Munoz, Eduardo J Naeem, Saad Abdin, Zain U Siddiqui, Humza F Cureus Cardiac/Thoracic/Vascular Surgery Carotid stenosis (CS) is a buildup of atherosclerotic plaque within the artery leading to a wide range of symptoms, from mild symptoms, including blurred vision and confusion, to much more life-threatening presentations, including paralysis due to stroke. The presentation is insidious, with symptoms exhibiting predominantly at severe stenosis; hence the emphasis is placed on the importance of early diagnosis, treatment, and lifestyle modifications. CS is seen undergoing almost the same pathogenesis of any atherosclerotic plaque formation, from endothelial damage of the artery lumen to the formation of a fibrous cap with a foam cell, lipid-filled core. The findings of our review article were consistent with the recent literature, depicting that comorbid hypertension, diabetes, and chronic kidney disease (CKD), and lifestyle aspects, including smoking and diet, played the most salient role in plaque development. Among several imaging modalities, duplex ultrasound (DUS) imaging is the widely preferred method in clinical practice. Carotid endarterectomy (CEA) and carotid stenting are the primarily advocated procedures for symptomatic severe stenosis, with similar long-term outcomes. Although, earlier clinical trials showed promising results in mitigating the risk of stroke among asymptomatic severe CS with surgical intervention. However, recent advancements have shifted the focus to medical management alone due to comparable results among the asymptomatic population. Both surgical and medical regimens are beneficial in treating patients, but it is still an ongoing debate as to which is predominantly superior. The currently advancing trials and research will help elucidate definitive guidelines. However, the massive impact of lifestyle modifications advocates some degree of individualized multidisciplinary management strategies. Cureus 2023-05-09 /pmc/articles/PMC10250083/ /pubmed/37303351 http://dx.doi.org/10.7759/cureus.38794 Text en Copyright © 2023, Ismail et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Cardiac/Thoracic/Vascular Surgery Ismail, Aqsa Ravipati, Shivani Gonzalez-Hernandez, Diana Mahmood, Hashim Imran, Alizay Munoz, Eduardo J Naeem, Saad Abdin, Zain U Siddiqui, Humza F Carotid Artery Stenosis: A Look Into the Diagnostic and Management Strategies, and Related Complications |
title | Carotid Artery Stenosis: A Look Into the Diagnostic and Management Strategies, and Related Complications |
title_full | Carotid Artery Stenosis: A Look Into the Diagnostic and Management Strategies, and Related Complications |
title_fullStr | Carotid Artery Stenosis: A Look Into the Diagnostic and Management Strategies, and Related Complications |
title_full_unstemmed | Carotid Artery Stenosis: A Look Into the Diagnostic and Management Strategies, and Related Complications |
title_short | Carotid Artery Stenosis: A Look Into the Diagnostic and Management Strategies, and Related Complications |
title_sort | carotid artery stenosis: a look into the diagnostic and management strategies, and related complications |
topic | Cardiac/Thoracic/Vascular Surgery |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10250083/ https://www.ncbi.nlm.nih.gov/pubmed/37303351 http://dx.doi.org/10.7759/cureus.38794 |
work_keys_str_mv | AT ismailaqsa carotidarterystenosisalookintothediagnosticandmanagementstrategiesandrelatedcomplications AT ravipatishivani carotidarterystenosisalookintothediagnosticandmanagementstrategiesandrelatedcomplications AT gonzalezhernandezdiana carotidarterystenosisalookintothediagnosticandmanagementstrategiesandrelatedcomplications AT mahmoodhashim carotidarterystenosisalookintothediagnosticandmanagementstrategiesandrelatedcomplications AT imranalizay carotidarterystenosisalookintothediagnosticandmanagementstrategiesandrelatedcomplications AT munozeduardoj carotidarterystenosisalookintothediagnosticandmanagementstrategiesandrelatedcomplications AT naeemsaad carotidarterystenosisalookintothediagnosticandmanagementstrategiesandrelatedcomplications AT abdinzainu carotidarterystenosisalookintothediagnosticandmanagementstrategiesandrelatedcomplications AT siddiquihumzaf carotidarterystenosisalookintothediagnosticandmanagementstrategiesandrelatedcomplications |