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
Carotid Treatments
Marc FITOUSSI M.D.
18-22 Queen Anne Street
W1G 8HU London
+44 20 7034 3326
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