Procedure for Carotid Endarterectomy

Carotid Endarterectomy

Carotid endarterectomy is the surgery done to relieve any obstructions present in the carotid artery thus preventing risk of stroke. Carotid arteries are the blood vessels which supply to the major part of the brain, and are felt on either side of the neck.

Carotid Artery Blockage Causes

Narrowing/stenosis of the carotid arteries is caused by gradual deposition of fatty substances (atherosclerosis), caused by numerous factors as listed below:

• Smoking.
• High cholesterol.
• Diabetes Mellitus.
• High blood pressure.
• More common in men.
• Family history of stroke or angina.
• Old age.
• Obesity and sedentary lifestyle.

Carotid Artery Disease Symptoms

Carotid artery blockage may be discovered accidentally on doctor’s examination with the presence of carotid bruit (whooshing sound present in the carotid artery) or when patient experiences a mini stroke (same signs of stroke but changes are reversible).

Diagnosis can be confirmed by carotid artery ultrasound etc.

Carotid artery blockage symptoms are seen only when the blockage advances giving rise to sudden symptoms of stroke (TIA – transient ischemic attack); the symptoms are:

1. Weakness and clumsiness of the limbs.
2. Drooping of face.
3. Slurred speech or difficulty in finding the right words.
4. Dizziness.
5. Numbness of any part of the body.
6. Severe headache.
7. Loss of vision in one or both eyes.

Treatment of Carotid Artery Stenosis/Blockage

Treatment of stroke is an emergency to avoid or minimize the brain damage. The patient is put on medicines to dissolve the clot. Surgical correction of the blockage is done by two methods:

1. Carotid Artery Stenting:

Carotid surgery risks are more in this procedure, as stroke can occur during such procedure.

2. Carotid Endarterectomy:

Carotid Endarterectomy procedure involves:

• Preoperative Assessment: Blood tests, ultrasound or X ray with dye (angiogram), ECG, echocardiogram, CT of brain, lung function tests.
• Hospital Stay: If the surgeon excludes carotid endarterectomy risks in preoperative assessment and feels that the patient is fit enough to go ahead with the procedure, hospital admission is done and patient is put on medication plan.
• Procedure: Under general anaesthesia an incision is taken at the angle of the jaw and the carotid artery is exposed and cleared of all the plaques.
• Patient is under observation for 24 hours and is discharged after 2-4 days.

Carotid artery surgery success rate is 98%, only two percent patients experience certain complications.

The carotid endarterectomy recovery includes vascular checks by the nurse and following instructions given by the doctor about:

• Rest.
• Limited physical activity.
• Wound care.
• Seek medical advice if there is fever, headache, nausea and vomiting, bowel or bladder problems, wound not healing properly.