Carotid Endarterectomy
What is a Carotid Endarterectomy?
A carotid endarterectomy is a surgical procedure designed to restore healthy blood flow to your brain by removing plaque buildup in the carotid arteries, the main arteries in your neck. This buildup can narrow the arteries, increasing the risk of a stroke.
If you’ve been diagnosed with significant carotid artery disease or are at risk for stroke, this procedure might be recommended to help reduce that risk and protect your brain’s blood supply. It’s a safe and effective way to address a serious health concern and improve your long-term well-being.
Risks & Benefits of a Carotid Endarterectomy
A carotid endarterectomy is a highly effective surgical procedure to prevent strokes by removing plaque buildup and restoring healthy blood flow to the brain. The benefits include long-term stroke prevention, proven success for patients with severe artery narrowing, and durable results compared to less invasive treatments.
However, as with any surgery, there are risks, such as stroke or heart attack during or after the procedure, nerve injury, infection, bleeding, or the possibility of the artery narrowing again (restenosis).
Compared to a carotid artery stent, which is a minimally invasive option with a shorter recovery time, carotid endarterectomy offers a lower stroke risk for many patients, particularly those over 70. Medical management, such as medications and lifestyle changes, is another alternative, particularly for those with less severe cases or for patients not eligible for surgery.
Ultimately, choosing the right treatment depends on the disease's severity, overall health, and individual risk factors.
What to Expect During a Carotid Endarterectomy Procedure
If you’re undergoing a carotid endarterectomy, understanding the steps involved can help ease your concerns and prepare you for the process. Here’s an overview of what typically happens before, during, and after the procedure.
How to Prepare
Before the surgery, your healthcare team will provide detailed instructions to ensure you’re ready. These will include:
- A Medical Evaluation: Your doctor will perform tests like ultrasounds or CT scans to assess the severity of artery narrowing and determine if surgery is right for you.
- Medication Adjustments: Before the procedure, you may need to stop certain medications, like blood thinners. Your doctor will provide specific instructions.
- Fasting Requirements: You’ll likely be instructed not to eat or drink for several hours before surgery.
- Transportation Planning: Arrange for someone to drive you home and assist with initial recovery after discharge.
During the Procedure
During a carotid endarterectomy, you can expect:
- Anesthesia: You’ll either receive general anesthesia (to sleep through the surgery) or local anesthesia with sedation (to numb the area and keep you relaxed but awake).
- Incision and Plaque Removal: The surgeon will make an incision on the side of your neck to access the carotid artery. Plaque buildup is carefully removed to restore blood flow.
- Artery Repair: The artery is repaired using stitches or a patch, ensuring it remains open and functional.
- Duration: The procedure typically takes about 1-2 hours.
After the Procedure
Your recovery process begins as soon as the procedure is finished. This typically involves:
- A Hospital Stay: Most patients stay in the hospital for one or two days for monitoring, especially to check blood pressure and ensure proper healing.
- Recovery and Restrictions: You’ll likely need to avoid heavy lifting or strenuous activities for a few weeks. Mild soreness in the neck is normal.
- Follow-Up Care: Regular check-ups with your doctor will monitor your recovery and the long-term success of the procedure. Lifestyle changes, such as a heart-healthy diet and quitting smoking, may also be recommended to maintain the benefits of the surgery.
Am I a Candidate for a Carotid Endarterectomy?
If you have carotid artery disease that puts you at significant risk of stroke, you might be a candidate for a carotid endarterectomy. Below are some common other signs or qualifiers that may indicate this procedure could benefit you:
- You have significant carotid artery narrowing (Stenosis)
- You have a history of Transient Ischemic Attacks (TIAs)
- You’ve had symptoms of a stroke
- You’re at low risk for surgery-related complications
- You’ve had limited success with non-surgical treatments
If you’ve been diagnosed with carotid artery disease, your doctor will assess your overall health, imaging results, and stroke risk to determine if carotid endarterectomy is the right choice for you.
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