Sténose

Sténose (stenosis) is the abnormal narrowing of a hollow organ, duct, or vessel in the body. It can be focal or diffuse and may result from congenital anomalies or acquired conditions such as atherosclerosis, fibrosis, inflammation, tumors, or external compression. The reduced diameter impedes flow or passage, which can lead to ischemia, obstruction, or reduced function depending on the location.

Common forms of stenosis include carotid stenosis, aortic stenosis and other valvular stenoses, spinal stenosis, renal artery stenosis, intestinal stenosis, and pulmonary stenosis. The clinical significance depends on the affected site: carotid stenosis raises the risk of transient ischemic attack or stroke; aortic and other valvular stenoses impair blood flow and may cause chest pain, syncope, or heart failure; spinal stenosis can produce neurogenic claudication; renal artery stenosis can trigger hypertension and kidney dysfunction; intestinal stenosis can cause partial or complete intestinal obstruction.

Symptoms, when present, reflect impaired flow or obstruction and vary by region. Many stenoses are asymptomatic until they become moderate to severe. Diagnostic evaluation relies on imaging: duplex ultrasonography for vessels, CT or MR angiography, and echocardiography for heart valves; invasive angiography as a confirmatory or therapeutic tool; endoscopy or cross-sectional imaging for abdominal or intestinal stenoses.

Treatment is individualized and depends on location, severity, and patient factors. Medical management focuses on risk factor control and symptom relief. Revascularization or corrective procedures include endarterectomy or stenting for carotid stenosis; valve replacement or repair for valvular stenosis; surgical decompression or minimally invasive dilation for spinal stenosis; angioplasty with or without stenting for renal or intestinal stenosis; balloon valvuloplasty for certain forms of pulmonary stenosis. In some cases, observation is appropriate if the stenosis is mild and asymptomatic. Prognosis varies with etiology, extent, and timely intervention.