Contents:
- Medical Video: Carotid Endarterectomy
- When do I need to do endarterectomy?
- What might happen after this procedure?
- What complications can occur?
Medical Video: Carotid Endarterectomy
Carotid endarterectomy is a procedure performed to remove plaque from the carotid artery in the neck to prevent stroke. The carotid artery is two large blood vessels located in the neck that supply blood to the brain. A plaque in the neck is formed by cholesterol buildup, blood clots, and debris that narrows the path of blood flow to the brain. When blood vessels narrow due to carotid plaque or carotid disease, this condition is called carotid stenosis.
Carotid plaques can cause strokes if several plaques hold and clog arteries anywhere in the brain.
When do I need to do endarterectomy?
Plaques of carotid blood vessels can be known for the first time after you experience warning signs of stroke, which is also often referred to as TIA (transient ischemic attack) aka mild stroke. It is important to note that TIA and stroke symptoms generally only occur on one side of the body and can include the arms, legs or face, weakness, difficulty speaking, inability to compose words, or even blindness in one eye. Often these symptoms can last only a few minutes, followed by full recovery and loss of symptoms. However, the second TIA and stroke is an emergency that requires immediate medical attention.
However, most carotid plaques and carotid stenosis occur in patients who have no symptoms at all. Vascular ultrasound in accredited laboratories is the most accurate, non-invasive, and cost-effective method. Sometimes the doctor may do this test if you hear an abnormal wheezing sound on the neck with a stethoscope.
In addition, this test is also done if you have many risk factors for cardiovascular disease, such as smoking, high cholesterol, diabetes, high blood pressure, or even a strong family history. Medical research shows that surgery in patients who have more than 70-80% of carotid artery stenosis can effectively reduce the risk of stroke partially over a lifetime (Bps and ACST study).
What might happen after this procedure?
The operation is painless because it is usually done under general anesthesia or general anesthesia. Recovery begins after awakening from surgery. On the night after surgery, you can usually begin to sit and drink fluids. Ice compresses are generally placed near the incision to reduce swelling. You can rest overnight under monitored conditions. The next morning, you can get up and walk, usually after eating a regular breakfast. Most patients can go straight home after surgery. At home, you can resume normal activities except lifting heavy items. Driving must be avoided for one to two weeks at the discretion of the surgeon. Numbness under the chin can occur and can usually improve over time. Overall most patients can return to driving and carry out all routine activities after two weeks of follow-up examinations.
Endarterectomy is one of the best surgical procedures to do, and in experienced hands can reduce the complication rate to very low. In addition, most patients tolerate surgery well and make recovery quickly.
What complications can occur?
Ironically, even though the treatment of carotid stenosis is designed to prevent strokes, the complications that can occur are strokes. An understanding of the best way to do this procedure has significantly reduced the rate of complications. If done by a trained, experienced, and qualified vascular surgeon, the risk of this complication is less than 1%. For example, an incision is made directly over a vein and if necessary, blood flow is diverted while the plaque is removed.
In the long term, advanced carotid ultrasound is recommended to be done twice a year. This is done to determine the progress of the disease and the condition of tissue congestion in the arteries undergoing surgery. However, less than one in ten patients re-experience narrowing of the arteries in their lifetime.
