Diagnosis of brachiocephalic arteries and their treatment
Blood supply of the brain offers several arteries: the brachiocephalic artery, the carotid and one of the branches of the left subclavian artery. Despite two additional source, atherosclerosis of the brachiocephalic arteries often leads to serious consequences.
The anatomy of this area of the bloodstream demonstrates duplex scanning also gives an insight into the seriousness of the consequences.
Circle of Willis circulation
Brachiocephalic trunk - branch of the aorta, the largest bulk vessel. Its branches - the artery that provides blood supply to the shoulder girdle on the right - right subclavian, right carotid and right vertebral. Circulation, still called Villesavin ring makes the blood flow to the brain is uniform and stable.
The deviation in any of the parts, forcing you to readjust the whole system. Redistribution of blood flow overloads the individual sections that in the long term can lead to stroke. Anatomy Willisau ring with its branchings such that the brachiocephalic artery most often affects atherosclerosis.
circle of Willis
Atherosclerotic plaques composed of cholesterol, are thicker in the artery wall. Like lumps, they grow on one or all sides simultaneously. Studying the nature of the appearance of these tubercles, the scientists blamed for their appearance of excess cholesterol in the blood.
The appearance of cholesterol formations in the interior of the artery narrows its lumen, it shows scanning. For certain this is reflected slightly. When it comes to brain blood flow, this situation becomes intolerable very quickly.
The patency of the brachiocephalic arteries is often reduced due to atherosclerosis. Additional trauma creates branching of the trunk, which demonstrates the scanning of the arteries. Patients with atherosclerosis, complain of dizziness that appears when turning the head or when the pressure is reduced. Growing plaque, robbing brain, reducing blood flow to it.
When the scanning of the arteries shows complete overlap between the plaque, the situation is even more threatening: she's not giving blood to fully move to the right carotid artery. Thus, atherosclerosis leads to a redistribution of blood to shift towards the right shoulder girdle.
Considering the atherosclerosis of the brachiocephalic arteries, doctors are paying attention to the increasingly young age of patients. Putting such a diagnosis, share the atherosclerosisdestinatarului and constrictive. The first is distinguished by the growth of plaques in length, they are not the cause of the loss of blood supply, but only reduce it. Stenosing atherosclerosis - the cause of serious hemodynamic plaques, growing across.
Violations are divided into primary, acute (encephalopathy or stroke), slowly developing, consequences of the transferred earlier acute disorders - strokes. Depending on the stage, choose treatment.
Diagnostic techniques: angiography, magnetic resonance angiography, duplex scanning, ultrasound triplex scanning.
Magnetic resonance method is not cheap, associated with the introduction of a contrast agent and x-ray load. The use of contrast agents makes the image particularly clear.
The gold standard became a triplex scanning of the arteries.
Study of the arteries
Scanning has been defined as a triplex with the ability to add color Doppler to the ultrasound radiation. This method of diagnosis is the core for the study of the main vascular that provide circulation to the brain.
During its carrying out have the opportunity to assess the condition of the common, external, internal, vertebral and carotid arteries cervical. Scanning reveals abnormalities that are the cause of violations of cerebral circulation, sometimes leading to strokes.
During the study, a well-rendered large arteries, the blood vascular at the periphery, surrounding tissues and small subcutaneous vascular. Thus, it is possible to evaluate the intensity of the flow at any section using color coding, Doppler. To diagnose atherosclerosis and to choose the treatment at an early stage helps to visual assessment of the lumen.
Triplex scanning allows to collect information about the state of the brachiocephalic arteries:
- the presence of blood clots, atherosclerotic plaques, detachment, expansion, stenosis;
- the patency or closure of the lumen, the presence of occlusions;
- bends, tortuosity, loops and other deformations;
- the normal size of the lumen, its hypoplasia (failure due to insufficient development), dilation - expansion, overloading;
- the mobility and elasticity of the vascular wall.
- changes of the arterial wall (thickening of the intima-media-adventitia), echogenicity, the surface shape;
- the presence or the threat of tears, aneurysm - protrusion of the arterial wall.
The analysis of the data obtained during the examination, provided the Doppler spectrum chart in color bloodflow, giving a complete picture of the lumen of the channel of each receptacle.
Modern equipment allows to detect pathology of each vessel at the earliest stage. During the examination, involved multiple sensors that give precise focusing, multiple zoom and ultra-high resolution images in real-time.
Indications for examination:
- treatment of hypertension;
- suspected atherosclerosis;
- of the manifestations vascular dystonia;
- any pathology of the heart;
- traumatic and toxic lesions of blood vascular;
- diseases of the blood;
- compression of the veins and arteries.
- the emergence of dizziness during change of position of a body;
- noise in the head or ears;
- headaches, associated with turning of the head;
- the appearance of short unconscious state;
- a feeling of numbness of limbs;
- the appearance of points and "flies", the other is the progressive deterioration of eyesight.
The treatment of the disease
Modern diagnostic methods detect not only the location of pathological constriction, and direction, the dynamics of the circulation in this area; this large-scale study helps to choose the treatment:
- medical regulation state.
The need for surgery is determined by the immediate threat of stroke.
If the operation is not necessary, the patient is on the account at the neuropathologist, and the treatment shall be elected individually.
Mandatory and common for patients with atherosclerosis is a regular consumption throughout the life of the blood thinners (aspirin, clopidogrel) and monitoring cholesterol levels. These measures - simple and effective prevention of stroke.
For surgical intervention there are three equal ways.
- Open surgery for removal of pathological arterial phase, with immediate replacement or closure.
- Endovascular intervention - the introduction of the stent into the pathological artery.
- Eversion carotid, endarterectomy is an open operation, during which the plaque is removed from the vessel, and then its integrity is restored.
Each treatment has advantages and is accompanied by difficulties. Stenting is a more modern, less traumatic method. But such intervention is expensive and not always acceptable. Therefore, this advanced method still has not replaced open surgery.