The carotid arteries are the blood vessels located on either side of the neck. When fatty deposits form on these arteries, carotid artery disease can occur. This condition can severely impact blood flow to the brain, which can cause stroke and other serious problems.
The build-up of plaque in the carotid arteries is called atherosclerosis. It limits blood flow to the brain and significantly increases the risk of stroke. Carotid endarterectomy is a procedure to remove plaque from the carotid arteries. It can be performed under local or general anaesthetic.
Carotid endarterectomy requires an incision to be made in the front of the neck and the opening of the carotid arteries. After the plaque is removed, the artery is repaired. This can be done using stitches or with a patch made using a vein or artificial material called patch graft.
Carotid endarterectomy is usually carried out when there is severe narrowing of the carotid artery and when a high risk of stroke has been identified. Symptoms of arterial narrowing may not be clear initially. In some cases, a TIA (Transient Ischemic Attack) may occur, revealing the extent of the problem.
Carotid endarterectomy is substantially more effective in dealing with damaged arteries than any available medication. It is often the best method for patients, particularly those at high risk of stroke. Strokes are caused when blood clots and travels up to the brain.
The build-up of plaque in the carotid arteries is usually identified through ultrasound. A CT scan or MRI may also be used. Your surgeon will carry out a full consultation and assessment to identify if you are a good candidate for carotid endarterectomy. He will assess a range of factors including the severity of the issue and any other medical conditions you may have.
Eversion Carotid Endarterectomy is a treatment method that involves cutting the impacted artery and turning it inside out before removing the plaque. The artery is then reattached. Your surgeon will assess whether this is an option in your case.
If a patient is deemed to be unsuitable for carotid endarterectomy, carotid angioplasty and stenting may be an alternative. In this procedure, a catheter tube with a small balloon is attached to the impacted artery by a blood vessel in the neck. The balloon is then inflated to widen the artery. A metal stent may also be inserted in order to reduce the chance of arterial narrowing in the future.
Procedure & Recovery
You will be asked to fast for a short period before the procedure. Your surgeon may also advise that you pause any medications you are using some time before the operation. Make sure to inform your surgeon of any medications you are taking.
Carotid endarterectomy usually requires a hospital stay of around five days or one week. Absorbable stitches may be used. If non-absorbable stitches are used they will be removed sometime after the procedure. A drainage tube may also be used to prevent the build-up of fluid. It will be removed 24-48 hours after the procedure.
You may have some degree of post-operative pain. Your surgeon may prescribe painkillers to deal with this. There may also be some bruising and numbness in the neck for some weeks after the procedure, but it should gradually fade. If you have excessive pain or if you notice any swelling in the neck, you should contact your doctor immediately.
An assessment will be carried out after the procedure to make sure it has been fully effective. You can also take measures to reduce the risk of plaque build-up reoccurring in the carotid arteries. These include reducing your intake of fat, exercising frequently and not smoking.
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