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Glossary

Annex
Amaurosis fugax :
a vision disorder of a single eye (appearance of a gray or black veil slowly descending before the eye—visual eclipse). Amaurosis fugax usually lasts from a few seconds to a few minutes. It must be taken very seriously and requires speedy medical attention as in the absence of therapy a much more serious neurological incident may follow and leave definitive sequelae.
Angiography :
a procedure, the purpose of which is to assess arterial narrowing (stenosis) or dilation (aneurysm). This procedure makes it possible to view the inside of arteries (arterial lumen).
Angioplasty :

Intervention that modifies the shape of a blood vessel.  As regards the carotid, angioplasties may take two forms:  a) surgical angioplasty, which consists in widening the carotid with a patch during the closure of the artery (see chapter on surgical treatment); b) endoluminal angioplasty which consists in widening the interior of the artery by inflating a balloon in the arterial narrowing.

Anticoagulant :
a drug blocking certain coagulation factors, which reduces the formation of blood clots. In carotid pathology, anticoagulants are sometimes used while the patient is waiting for a surgical procedure or when the patient suffers from another realted illness requiring such treatment.
Aphasia :
a difficulty or impossibility in speaking.
Arterial lumen :
the inner part of an artery. The part where blood circulates, the narrowing of which is called a stenosis.
Asymptomatic :
that which does not produce any symptoms. A patient with asymptomatic carotid stenosis does not experience any disorders related to such carotid stenosis.
Atheromatous plaque :
deposits of fatty tissues in the arterial wall, which thicken and protrude into the arterial lumen, thus causing a stenosis.
Atheromatous ulcer :
a residual cavity located in an atheromatous plaque that communicates with the arterial lumen. Such ulceration sometimes occurs following a plaque necrosis or a hematoma opening into the arterial lumen. It may contain necrotic debris.
Blood clot :
a semi-solid element made up of red blood cells held in a fibrous network. Blood clots normally plug injured arteries. When they form abnormally and migrate into arteries, they may cause an arterial occlusion and an ischemia or an infarction. They can be dissolved by means of a fibrinolytic therapy, which destroys fibers and frees red blood cells.
Carotid bifurcation :
an arterial segment including the end of the common carotid artery and its division into the external carotid artery (vascularizing the face) and the internal carotid artery (vascularizing the brain). It is in that segment that most of atheromatous carotid plaques build up and that carotid surgery is performed. There are two carotid bifurcations, one on the right side and one on the left.
Carotid occlusion :
a total interruption of circulation in one of the carotid arteries. Occlusion is usually observed when atheromatous plaque brings about a stenosis that is so narrow that blood can no longer flow in the carotid artery. Blood stagnates and coagulates. The blood clot extends gradually toward the brain and often stops before reaching the cerebral arteries. This explains why a carotid occlusion may not be accompanied by any disorder (asymptomatic carotid occlusion).
Carotid siphon :
the terminal segment of the internal carotid artery.
Carotid suture :
a closure of the arterial wall of a carotid artery with a very fine filiform suture.
Catheter angioplasty :
A system consisting of a  very small hollow tube at the end of which is fixed an inflatable minute cylindrical balloon.  The system is designed to be inserted in the stenosis and inflated in order to widen the arterial narrowing (endoluminal angioplasty). 
Cerebral hemisphere :
one side of the brain. Each cerebral hemisphere is vascularized by a carotid artery. The right hemisphere controls the left hemicorpus (and language in left-handed persons). The left hemisphere controls the right hemicorpus (and language in right-handed persons).
Cerebral infarction :
destruction of a portion of the brain’s tissue.
Cerebral M.R.I. (magnetic resonance imaging) :
virtual cross sectional views of the brain obtained with equipment using a magnetic field. This procedure allows searching for a cerebral infarction and provides much more information to physicians.
Clamp :
a surgical instrument used to block circulation in a vessel by compression.
Clamping :
positioning of a clamp. Blocking circulation within a vessel.
Common carotid artery :
there are two common carotid arteries. The right common carotid artery arises from the brachiocephalic arterial trunk. The left common carotid artery arises directly from the aorta. Both rise into the neck and divide into two arteries in the middle of the neck, the internal carotid artery and the external carotid artery.
Communicating arteries :
the arteries in the brain, which allow communication between both carotid arteries (anterior communicating artery) or between a carotid artery and a posterior cerebral artery (issued from the division of the basilar artery) toward the back (posterior communicating arteries). The communicating arteries form a loop called the circle of Willis. They allow vascularizing a cerebral hemisphere when a carotid artery is occluded (clogged) and thus avoiding ischemia in that cerebral hemisphere and hemiplegia. But not everybody has communicating arteries that function properly, which explains why hemiplegia may occur when a carotid artery becomes very stenosed or occluded.
Computed cerebral tomography :
a virtual cross sectional view of the brain obtained with an X-ray machine.
Computed tomographic angiography (C.T.A.) :
an angiography by reconstruction from scanned cross sectional views. This procedure requires iodine injection.
Contralateral :
on the other side in relation to a reference element (a right cerebral infarction causes a left hemiplegia).
Conventional angiography :
an angiography by means of injection of an iodine medium (which blocks X-rays) into an artery (through a catheter).
Dysarthria :
difficulty in speaking.
Embolism (arterial embolism) :
a migration of a fragment of tissue or a blood clot into an artery. Arteries divide into smaller and smaller arteries. When an embolus arrives at an artery that is too small for him, it stops and blocks the arterial circulation in that artery. Oxygen can no longer reach the tissues vascularized by that artery, and they become necrosed (infarction).
Embolus :
a blood clot or debris carried into the blood circulation.
Endarterectomy :
Ablation of atheromatous plaque. When atheromatous plaque develops in the internal layers of an artery wall, it is necessary to remove such internal.
Endoluminal angioplasty :

Endoluminal angioplasty consists in widening a stenosis by operating inside the artery.  The balloon angioplasty (an inflatable cylindrical balloon fixed at the end of a catheter) is introduced into  the artery and is pushed until it is inserted in the narrowed segment.  The action of  inflating the minute balloon compresses the atheromatous plaque, thus widening the artery.

External carotid artery :
an artery vascularizing the face and the neck from numerous division branches (superior thyroid artery, facial artery, lingual artery, etc.). There are two external carotid arteries, one on the right side and one on the left.
Facial paralysis (or Bell’s palsy) :
a paralysis of facial muscles.
Filter :
A filter is used during certain endoluminal angioplasty. This filter is placed downstream from the arterial area which is to be dilated.  Its purpose is to capture the atheromatous debris that may be released into the blood stream during the process of dilatation.
Hematoma :
blood leaking out into tissues. Such blood leaks are in general secondary to the rupture of a blood vessel.
Hemiparesis :
difficulty in moving one side of the body.
Hemiplegia :
paralysis of one side of the body.
Homolateral :
on the same side.
Internal carotid artery :
an artery vascularizing the brain.
Ischemia :
an injured tissue that is no longer supplied with blood and thus no longer supplied with oxygen. Ischemia may lead to an infarction when the arterial circulation is not quickly re-established.
Ischemic stroke :
a neurological disorder related to ischemia (insufficient vascularization) and destruction of a portion of the brain tissue (cerebral infarction).
M.R.A. (magnetic resonance angiography) :
an angiography using a magnetic field. This procedure is better tolerated than conventional angiography as it requires neither catheter progression nor iodine injection.
M.R.I. (magnetic resonance imaging) :
see cerebral M.R.I.
Mural thrombosis :
a blood clot forming in contact with a damaged arterial wall.
Necrosis :
liquefaction of a tissue. The necrosis of atheromatous plaque brings about the formation of a cavity. Such a cavity fills up with liquefied tissues and plaque debris. As long as necrosis remains confined to the plaque, there is no risk of neurological incident. When necrosis extends toward the carotid artery lumen, and if the necrosed cavity ruptures into the arterial circulation, plaque debris is carried away in the blood flow toward the cerebral arteries, which can be occluded.
Neurological sequelae :
those neurological disorders that persist for some time after a cerebral ischemic incident.
Ocular stroke :
a vision disorder of a single eye, which does not completely regress and leaves definitive sequelae.
Orthophony :
language reeducation following aphasia or dysarthria.
Patch :
a small piece of cloth (usually Dacron, a few millimeters wide and a few centimeters long) used by surgeons to enlarge an artery at the time they close it (suture).
Platelet-inhibitor drug :
a drug reducing the platelet’s adherence to one another, thus reducing the formation of blood clots.
Post-hemiplegia rehabilitation :
exercises designed to enhance recovery of functions in a limb or a limb segment. Rehabilitation is accomplished with the help of a physiotherapist.
Sequelae :
see neurological sequelae.
Shunt :
a flexible plastic tube, which allows proper blood-flow to the brain during carotid surgery when necessary.
Siphon :
see carotid siphon.
Stent :
Small cylindrical metal mesh tube that is placed in the dilated stenosis to push back  the atheromatous plaque in order to avoid the recurrence of the stenosis and to limit the risk of  migration of debris in the circulation.  In the carotid angioplasty, the stent is often applied before angioplasty.
Stroke :
a neurological disorder usually occurring quite suddenly. This term covers both cerebral ischemic stroke and cerebral hemorrhagic stroke.
Suture :
see carotid suture.
Symptom :
a visible sign of illness (paralysis, language disorder, vision disorder, etc.).
Symptomatic :
that which produces symptoms.
T.I.A.(transient ischemic attack) :
a neurological disorder related to an ischemic injury to a portion of the brain tissue and lasting less than 24 hours.
Thrombosis :
an arterial occlusion caused by a thrombus (blood clot resulting from blood stagnation). See also mural thrombosis.
Transient monocular blindness :
see amaurosis fugax.
Ulcer :
see atheromatous ulcer.
Vascularized :
supplied with blood (vessels). When a tissue is no longer vascularized it becomes ischemic and there is a risk of infarction.

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