Carotid Artery Surgery

Carotid Artery Surgery

 Carotid artery surgery is a procedure to restore proper blood flow to the brain. The carotid artery brings needed blood to your brain and face. You have one of these arteries on each side of your neck. Blood flow in this artery can become partly or totally blocked by fatty material called plaque. This can reduce the blood supply to your brain and cause a stroke.

There are two invasive ways to treat a carotid artery that has plaque buildup in it. This article focuses on a surgerycalled endarterectomy. The other method is called angioplasty with stent placement.

Description

During carotid endarterectomy:

• You receive general anesthesia. You are asleep and pain-free. Some hospitals use local anesthesiainstead. Only the part of your body being worked on is numbed with medicine so that you do not feel pain.You will be given a medicine to help you relax.
• You lie on your back on an operating table with your head turned to one side. The side your blockedcarotid artery is on faces up.
• The surgeon makes a cut (incision) on your neck over your carotid artery. A flexible tube (catheter) is put inplace. Blood flows through the catheter around the blocked area during surgery.
• Your carotid artery is opened. The surgeon removes the plaque inside the artery.• After the plaque is removed, the artery is closed with stitches. Blood now flows through the artery to yourbrain.
• Your heart and brain activity will be monitored closely during surgery.

The surgery takes about 2 hours. After the procedure, your doctor may do a test to confirm that the artery hasbeen opened.

Why the Procedure is Performed

This procedure is done if your doctor has found narrowing or a blockage in your carotid artery. Your doctorwill have done one or more tests to see how much the carotid artery is blocked.

Surgery to remove the buildup in your carotid artery may be done if the artery is:

• Narrowed by more than 70%
• Narrowed between 50% and 70% and your doctor thinks you have a very high risk of having a stroke If you have had a stroke, your doctor will consider whether treating your blocked artery with surgery is safe foryou.

Other treatment options your doctor will discuss with you are:

• No treatment, other than tests to check your carotid artery every year
• Medicine and diet to lower your cholesterol
• Blood-thinning medicines to lower your risk of stroke. Some of these medicines are aspirin, clopidogrel(Plavix), and warfarin (Coumadin).

Carotid angioplasty and stenting is more likely to be used when carotid endarterectomy would not be safe. Go to the emergency room or call the local emergency number (such as 911) as soon as symptoms occur. Whenhaving a stroke, every second of delay can result in more brain injury.

The following can help prevent a stroke:

• Adults should have their cholesterol checked every 5 years and treated, if needed. If you have beentreated for high cholesterol, you will need to have it checked more often.
• Avoid fatty foods. Follow a healthy, low-fat diet.
• Do not drink more than 1 – 2 alcoholic drinks a day.
• Exercise regularly: 30 minutes a day if you are not overweight; 60 – 90 minutes a day if you are overweight.
• Get your blood pressure checked every 1 – 2 years, especially if high blood pressure runs in your family. Ifyou have high blood pressure, heart disease, diabetes, or you have had a stroke, you need to have itchecked more often. Ask your doctor.
• Quit smoking.

The following tests may be done:

• Blood cholesterol and triglycerides test
• Blood sugar (glucose) testo Ultrasound of the carotid arteries (carotid duplex Doppler study) to see how well blood is flowing throughthe carotid artery
• Carotid or cerebral angiography
• Computerized tomographic angiography (CTA)o Magnetic resonance angiography (MRA)

Treatment options include:

• Blood-thinning medicines such as aspirin, clopidogrel (Plavix), and warfarin (Coumadin) to lower your riskof stroke
• Medicine and diet to lower your cholesterol
• Medicine and diet to control your blood pressureo No treatment, other than checking your carotid artery with tests every year