Occlusion in the carotid vein (carotid artery)

Stenosis in the carotid vein, known as the jugular vein, is seen especially after the age of 40. The narrowing of the carotid artery leads to occlusion in the advanced stage.
The main cause of narrowing of the jugular vein is atherosclerosis. Sometimes, damage to the vein can occur after a blow to the vein, that is, after a trauma.
Occlusion of the carotid artery; It can cause paralysis such as vision loss, speech disorder, inability to understand what is being said, not being able to move an arm-leg or both. Facial paralysis may occur in the patient due to the obstruction. All these are manifested by symptoms such as dizziness, nausea, vomiting.

. What kind of a problem can occur in the carotid vein, or as it is popularly known, in the “Junk Vein”?
The most common problem we see in the carotid artery is narrowing. If the patient has atherosclerosis, which we see frequently, especially after the age of 40. Just as certain parts of the body, especially the heart vessels, narrow and the amount of blood passing through it decreases, stenosis can also occur in the carotid artery.

. Is occlusion of the carotid artery the same thing as carotid stenosis?
Things that complement each other. First the stenosis develops and the stenosis progresses and becomes occluded one day.

. What are the symptoms of narrowing of the jugular vein? Do the symptoms differ in case of blockage?

In case of narrowing, two types of symptoms may occur. One of them is the disruption of the activities of that region, as not enough blood can go to that part of the brain. Also, when blood cannot pass easily because of the stenosis, a small clot forms there, or a piece that breaks off from the fat accumulation that causes the stenosis and clogs a vessel in the brain, and the area where it occludes the vessel becomes paralyzed.

As a result, vision loss, speech disorder may occur, inability to understand what is being said may occur, a paralysis such as inability to move an arm or leg or both, facial paralysis may occur, dizziness, nausea, and vomiting may occur. These are all symptoms of brain blockage.

Some of these may be temporary and will pass in a day or two. We call it a transient ischemic attack, it dissolves on its own or it dissolves with treatment and starts working again. If this does not pass, it will appear as a stroke and paralysis.

. Who is more likely to have the problem? Is there a difference between men and women? Is it a problem that occurs more in the middle-aged?
It usually happens after the age of 40. If the patient has a problem that will cause other vascular problems, these are more common. For example, if the patient has diabetes, has problems in terms of blood fats, has high bad cholesterol, it is more common in people like some kidney patients.

It is seen in people who do not pay attention to their diet, if they have features that will cause arteriosclerosis in terms of lifestyle, it is more common in these people and these conditions are generally seen a little more frequently in men.

. What are the causes of stenosis in the jugular vein?

The main reason for the narrowing is atherosclerosis, and sometimes the vein may be damaged after a trauma or a blow to the neck, and one or two of the vascular layers, which we call dissection, may separate from the wall and narrow the blood flow, which can also be seen in young patients.

. How is the diagnosis made?
Imaging methods are needed for diagnosis after clinical examination; It can be looked at with Doppler, MR angiography, CT angiography can be done, but the most accurate result is angiography with a catheter.

. What methods can be used in the treatment?
Three strategies are followed in the treatment, if the stenosis is not too much and does not cause any complaints in the patient, the patient can be followed up with blood thinners. If the patient’s complaints do not go away or the stenosis is more than 70 percent, then it is necessary to expand this stenosis, there are two ways to widen it. One is to open the vein with open surgery and scrape the lime deposits inside. The other is to enter the groin with the angiography method, go there, place a stent and expand it.

. How is stenting performed in stenosis in the jugular vein?
Stent application is done by entering from the groin, there are thin long pipes called catheters, we can easily exit the carotid vein. First, we send a wire through the catheter, there is a closed umbrella at the end, and after the stenosis passes, we open the umbrella with this wire and that umbrella allows blood to flow.

. In which cases is a stent recommended? Is the location of the occlusion in the carotid artery and the degree of stenosis important? Are there cases where stent cannot be inserted?

There are patients who cannot have a stent inserted. Just as there are patients who cannot be operated on, there are also patients who cannot be stented. Either the stent cannot be opened there if there is too much calcification, or if the shape of the vessel prevents us from reaching there, if it is too curved, it may not be possible to move the stent there.

It is not possible to place a stent in a patient group of 3-5 percent, or the work to be done may become more risky than surgery. While answering the question of which treatment is appropriate; It is decided according to the characteristics of the patient, the nature of the stenosis and the structure of the vessel.

. Are stent applications to the carotid artery performed in the operating room? Are patients anesthetized? Does the procedure require a hospital stay?
Stent application is performed in the angiography unit of the hospital. There is no need to put the patient to sleep, we just inject an anesthetic into his groin. No other anesthesia is needed. After the procedure, we keep the patient in the hospital for one day. The patient can return to his daily life one or two days after the procedure.

. What are the advantages of stenting? What conveniences does it bring compared to surgery?
Firstly, it is not necessary to give anesthesia to the patient, secondly, it is possible to stay in the hospital for a day, and if he rests for a day or two, he can return to his daily activities.

. What complications may occur during or after stenting?
There is some risk in every job. It is also available in open surgery and stenting. Damage to the vessel during the procedure and escaping a clot despite the filter is very unlikely, but not zero.

. Which specialists can perform carotid stent applications?

The truth of the matter is that it is done by a neuroradiologist, because in case of a possible problem, the brain is damaged, and it may be necessary to make interventions in some vessels in the brain.

For example, if a cardiologist performs this procedure and a problem arises, he or she is not accustomed to the vessels in the brain and is not prone to these applications, so they cannot fix the problem and then they ask for help from the neuroradiologist, but sometimes it may be too late.

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