TREATMENTS

1 - surgery : wich patients ?

11 - Surgery  patients with sténosis > 70% symptomatic or not

It increase the stroke risk  of 80% for symptomatic stenosis and et 50 % for  asymptomatic stenosis. 

The surgical team must be sepcialised in vascular surgery and having a rate of  morbi-mortality < 3% for asymptomatic stenosis and < 6% for symptomatic stenosis

12 - no surgery :  patients with moderate stenosis

2 - Correcting vascular risk factors using hygienic measures and dieting can bring hope for controlling and stabilizing this disease.

-High blood pressure multiplies by 7 the risks of ischemic strokes and by 10 the risks of hemorrhaging strokes

-Smoking multiplies by the 2 the risk of strokes. The risk drops to x1.2 for former smokers.

-Diabetes increases the chances of cerebral infarctions and their severity.

-Hypercholesterolemia: its role is not as important as for other atheroma locations.

-Obesity.

3 - Medications

Anti-platelets treatment  :  Aspirine  75 mg to 300 mg per day , - Clopidogrel  (PLAVIX)

Anti-platelet treatment lasts a week; as long as the time it takes for the blood to renew its platelets.

Side effects are mostly digestion-related. 

An anti-platelet treatment is absolutely crucial for benign or mildly narrow carotid stenosis (not needing surgery) as well as after surgery.  

This therapeutic approach has shown its efficacy: A 20% decrease in cerebral strokes and a 30% decrease in myocardial infarction.

- cholesterol treatment:   statines

- hypertension treatment

-  diabet treatment