Carotid artery stenosis and cerebral infarction The carotid artery provides more than 80% of the blood supply to the brain tissue. In addition to the reduction of blood supply to the brain caused by carotid stenosis, cerebral infarction often occurs due to the fragmentation of atherosclerotic plaques in the stenosis and the dislodging of local thrombosis emboli. 60% of cerebral infarction is caused by extracranial vascular disease,. Treatment of carotid artery stenosis is an important tool for stroke prevention. Development of carotid stenosis treatment The traditional treatment is surgery, i.e., performing carotid endarterectomy. In the past 50 years, this procedure has contributed greatly to the prevention of cerebral infarction. In the last decade, with the development of endovascular interventional techniques, carotid endoluminal angioplasty and carotid stenting have become increasingly mature, especially the development of cerebral protection technology, which provides safer conditions for carotid stenting technology. Carotid stenting is a minimally invasive treatment technique that uses special devices to place metal stents in the carotid artery stenosis through the lumen of the vessel, thereby dilating the stenotic vessels to ensure normal blood flow and prevent emboli from falling out. It is a new and advantageous technique for the treatment of carotid artery stenosis and prevention of stroke because it is less invasive, easier to operate, has fewer complications, and has an effect comparable to that of traditional surgery. Carotid artery stenting Symptomatic carotid artery stenosis refers to minor stroke (TIA) episodes such as transient blackness or numbness and weakness of the limbs, or those who have had a previous stroke and have basically returned to normal after treatment. For these patients, the treatment criteria should be slightly relaxed, e.g., treatment can be considered for carotid artery stenosis >50% on the corresponding side. Patients without symptoms should be considered only if the stenosis is above 70%. Patients with severe stenosis of 70% to 99% are more suitable for this treatment because they are more likely to have a stroke at this time. Stenting is also more appropriate for older and frailer patients, patients with more difficult surgical techniques, and patients with restenosis requiring retreatment. Stenting is simple and minimally invasive, and is usually performed under local anesthesia. The procedure is completed by simply puncturing the femoral artery at the root of the thigh for angiography, delivering the stent to the stenosis with a special pusher and releasing it, and dilating it if necessary. Stenting eliminates the complications of surgical anesthesia and neck surgery injuries. With the development of medical technology, a variety of intraoperative brain protection devices have been developed, which are delivered distal to the stenosis before treatment, where they are released to form an “umbrella” like filter device with many small holes in the “umbrella cloth” to allow blood to pass through. After the operation is completed, the filter can be closed up like an umbrella, and the plaque and thrombus that are collected in it can be taken out of the vessel. In this way, the incidence of stroke during carotid stenting is reduced (1%~5%). The incidence of ischemic cerebral infarction in Europe and America used to be higher, but through decades of active prevention, the incidence has been significantly reduced. In our country, most people still only use general drugs for prevention, and the concept of active prevention is not enough, which is an urgent problem to be solved. First, it is necessary to establish the concept that stroke can be actively prevented. Active treatment of carotid stenosis and prevention of stroke, endovascular stenting is the main means at present. How do you know if you have carotid stenosis? We divide patients into two categories, those who are asymptomatic and those who are symptomatic. The asymptomatic ones are not easy to detect, but they make up the majority. How do you detect them? We say that if you are a person who values your quality of life, you should undergo some necessary tests, especially if you are over 50 years old and have hypertension, coronary artery or peripheral arteriosclerosis, you should consider a carotid ultrasound to exclude carotid artery stenosis. Some patients with carotid stenosis show some symptoms, a common symptom is cerebral ischemia (TIA) attack, which is characterized by sudden onset of dizziness, temporary darkness in one eye, numbness and weakness in arms and legs, and slurred speech. This symptom can occur in just a few minutes or hours, but disappears completely within 24 hours, which is often referred to as a “mini-stroke”. In this case, do not delay, should quickly go to the doctor. Patients who have already had a cerebral infarction should also be checked for carotid stenosis as long as they are recovering well, because these patients will have another cerebral infarction, often a more serious one, and if the possible carotid stenosis can be treated in time, the chance of a stroke will be greatly reduced. How to check for carotid stenosis? It is very simple. A carotid ultrasound can be performed when available to make a diagnosis.