Friday, April 19, 2024

Is Carotid Artery Surgery Dangerous

How To Prevent Re

Carotid Artery Disease & Stroke Angioplasty – Dr. May Nour | UCLAMDChat

Having a successful carotid artery surgery does not necessarily mean that there will not be a further blockage in your arteries. In order to prevent re-narrowing of the arteries:

  • The patient should eat a healthy and balanced diet. If the doctor advises, the patient should exercise.
  • The patient should make efforts to quit smoking and reduce the stress level.
  • The patients will be advised to keep a check on his cholesterol and blood pressure level. If the patient is told to take medicines for it, he should.

Is 50 Blockage In The Carotid Artery Bad

The operation is recommended for symptomatic individuals with carotid-territory transient ischemic episodes or small strokes who have 70 to 99 percent carotid artery stenosis. Carotid endarterectomy, with a minimal surgical risk, gives a moderate benefit of 50 to 69 percent in symptomatic patients with carotid artery stenosis. The benefits appear to increase as the severity of the disease increases.

Carotid endarterectomy should be considered in asymptomatic individuals with severe carotid artery stenosis to reduce their risk of future neurological events. Carotid endarterectomy may also be considered in asymptomatic individuals with less than 70% carotid artery stenosis if they are at high risk for future adverse events .

Individuals who are not eligible for surgery but who would like to lower their risk of future neurological events can take medications that reduce blood pressure, cholesterol, and glycemia prevent heart attacks and strokes by reducing blood clotting and reduce inflammation. These include aspirin, ticlopidine , clopidogrel , dipyridamole , pentoxifylline , heparin, and warfarin .

Intervention For Carotid Stenosis

The benefit of surgery depends on the experience of the surgeon performing the operation and the overall health of the patient. In general, a surgeon performing Carotid Endarterectomy should have a complication rate of less than 6% in patients with symptoms and less than 3% in patients without symptoms. Experienced surgeons often have complication rates significantly less than that. It is important to know the surgeons results before considering surgery.

Also Check: Can I Buy Insurance To Cover Bariatric Surgery

Symptoms Of Carotid Artery Disease

Any adult patient who has a stroke or Transient Ischemic Attack should be checked for disease of the carotid arteries in the neck. However, most patients with carotid artery disease are asymptomatic. In these patients, carotid stenosis can be suspected when a noise, or bruit, in the neck is heard with a stethoscope during a physical examination. While there may be several causes for such a bruit, individuals over the age of 60, or with a history of stroke, myocardial infarction, coronary bypass or angioplasty PVD, and/or smoking are more likely to have carotid disease. Significant carotid stenosis is rare in the overall adult population , but is present in 20-30% of individuals with stroke or TIA and in 5-10% of patients with a bruit who are over 60, smokers or have a history of coronary or peripheral artery disease.

What Is Carotid Artery Disease

Carotid Artery Disease

Carotid Artery Disease is a disease in which the blood vessels in the neck, which are responsible for carrying blood from the heart to the brain, narrow. This condition may be caused by cholesterol buildup in the blood vessels, also known as atherosclerosis. Blood clots can form here and travel up into your brain.

You may have this condition for a long time before you have any symptoms. The most common symptoms include:

  • Transient ischemic attacks, more commonly referred to as mini-strokes
  • Strokes, which are known to occur when the blood supply to your brain is either interrupted or seriously reduced
  • Temporary loss of vision in one of your eyes

The most common symptoms are mini-strokes or strokes. When this condition is discovered because youâve had a stroke or mini-stroke, the blood flow to your brain may be improved by taking blood thinners and cholesterol-lowering medications. However, if thereâs severe narrowing to the blood vessels leading to your brain, you may need surgery to open the blood vessel.

Your likelihood of needing surgery grows if you have carotid artery blockages. These occur when plaque clog the blood vessels responsible for delivering blood to your brain and head. These blockages will increase the likelihood that youâll have a mini-stroke or a stroke.

You May Like: Healing After Skin Cancer Surgery

Do You Feel Better After Carotid Artery Surgery

After surgery, most people can return to normal activities within three to four weeks. Although, many get back to their daily routines as soon as they feel up to it. During the first few weeks of your recovery, some key things to keep in mind include: You may have some soreness in your neck for about two weeks.

What Happens After Carotid Endarterectomy

Most people stay overnight in the hospital to watch for problems after their procedure.

You may have a temporary drain in your neck to remove fluid where your provider made an incision. This drain will usually only stay in for one day.

Your healthcare provider will discuss the results of your procedure with you. For most people, this procedure helps prevent further brain damage and reduces the risk of stroke. However, unless you adopt a healthier lifestyle, plaque buildup, clot formation and other problems in the carotid arteries can return.

Recommended Reading: Should I Have Weight Loss Surgery

Why Is Carotid Artery Surgery Performed

Your doctor may recommend carotid artery surgery to treat carotid artery disease. Carotid artery disease is a buildup of plaque inside the carotid arteries. This narrows the carotid arteries and can eventually block them completely. This reduces blood flow to the brain and increases the risk of stroke.

Your doctor may only recommend carotid artery surgery if other treatment options with less risk of complications have been ineffective. Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on carotid artery surgery.

Carotid artery surgery treats carotid artery disease with any of the following conditions:

  • Carotid artery stenosis of 60% or greater. Carotid stenosis is a narrowing of the carotid arteries. Your doctor may decide that carotid artery surgery is a good treatment for you if your carotid arteries are narrowed by 60% or more. This is true even if you do not have symptoms and have not had a stroke or a TIA.

  • Prior stroke, which occurs when the flow of blood to the brain stops

  • Prior transient ischemic attack , a group of stroke-like symptoms that generally resolves within 24 hours. A TIA is a warning sign that you are at risk for a stroke.

What Is The Recovery Time

New fix for carotid artery disease

Recovery from a carotid endarterectomy is rapid. Most people go home the day after the procedure. After you get home, its OK to shower. Just dont scrub the surgical glue or let the stream of water hit it.

Check your incision daily and avoid putting any lotions on it. Avoid wearing clothes that rub against your incision.

You can go back to most of your normal activities in three or four weeks. You can drive after your incision heals and it doesnt feel uncomfortable to turn your head. The area near your jawline and earlobe may feel numb for six months to a year.

Don’t Miss: Transgender Surgery Male To Female

What Happens Before A Carotid Endarterectomy

In addition to a physical exam, you may have tests a few days before your procedure to ensure its safe to perform the surgery. Your surgeon may order a cerebral angiogram to better define your brains anatomy. A cerebral angiogram is an invasive diagnostic test that produces X-ray pictures of the inside of blood vessels in your head.

In many instances now, however, your healthcare provider may get this information from either a CT angiography or MR angiography. These are noninvasive methods to obtain information about your carotid arteries and your brain, and these can be performed without risk of stroke.

You may need to stop taking certain medications before your carotid endarterectomy, so be sure to tell your healthcare provider about everything you’re taking . Your healthcare team will give you specific instructions to help you prepare for your procedure. Most people will remain on aspirin through the procedure. Its important to check with your healthcare provider before stopping aspirin or clopidogrel if youre on these medications.

You should also stop using tobacco products before your surgery.

What Should You Expect During And After Surgery

When youâve been told you need surgery for your carotid artery blockages, you may find yourself wondering what you should expect. One of the main things you should expect is for the incision in your neck to be sore for around a week after youâve had your surgery. Initially, the area around your incision may be swollen and bruised. You may also experience numbness in the area in front of the incision, which will be around your jaw and earlobe. This numbness should get better in about 6 to 12 months after the surgery.

While it will take some time for the discomfort to go away, you should be able to return to your normal activities about three or four weeks after surgery. Your doctor may let you get back to your daily routine as soon as you feel up to it, though.

Expect to need some help with meal preparation and housekeeping throughout your recovery. You should not drive until your incision is healed and you can turn your head without any discomfort. You should have someone drive you home from the hospital after your surgery.

You May Like: How To Get Insurance To Pay For Bariatric Surgery

Purpose Of Carotid Artery Surgery

Carotid artery disease can lead to a stroke. These blockages can be caused by plaque or by a blood clot that has clogged the artery. By performing a CEA, your doctor helps to keep blood flowing to your brain in order to prevent strokes.

Carotid artery surgery also helps prevent a transient ischemic attack . A TIA has the symptoms of a stroke such as numbness, difficulties with speech or vision, and trouble walking but they last for a brief time.

According to the , symptoms of a TIA usually disappear within an hour but may persist for up to 24 hours. Like a stroke, a TIA is caused by a temporary blockage of blood to the brain.

Your doctor might recommend CEA if you meet certain criteria, such as when:

  • youve already had a stroke
  • youve already had a TIA
  • the blockage of your carotid artery is severe but not complete

Diagnosis Of Carotid Artery Disease

Reducing Your Risk of Stroke: Carotid Artery Surgery  Neurosurgeon News

Carotid artery disease is easily checked by Carotid Duplex Ultrasound. This is a simple non-invasive study that can detect plaque in the carotid arteries and determine the degree of blockage. You should talk with your primary care physician about whether or not you meet the criteria for a carotid ultrasound. Remember, not all insurance will pay for carotid ultrasound in patients without symptoms. Like PAD, the major long-term risk of carotid disease is myocardial infarction and cardiac evaluation along with risk reduction is very important in overall management.

You May Like: Lens Replacement Surgery Pros And Cons

What Are The Advantages Of Carotid Endarterectomy

A carotid endarterectomy can be highly beneficial in preventing future strokes if you’ve already had one, possibly cutting your risk by one-third in the three years after surgery. Most people tolerate the procedure well.

Even with a successful procedure, your healthcare provider might recommend:

  • Improving your diet.
  • Starting to exercise .
  • Not using tobacco products.

However, with an experienced surgeon, there’s minimal risk.

The risks of a carotid endarterectomy vary, depending on:

  • The severity of your carotid artery disease.
  • The location of the blockage.
  • Whether you’ve had a previous stroke.
  • The presence of other coexisting medical conditions, such as diabetes or kidney disease.

If your healthcare provider recommends this surgery as a treatment option for you, talk with them about why they recommend the procedure, the benefits and risks, and the hospital’s surgical outcomes.

While the operation can result in some neck pain for about two weeks afterward, you can take standard, over-the-counter pain medications to relieve it.

Why Does One Have To Undergo Carotid Artery Surgery

Carotid arteries are primarily located on either side of a persons neck. These are special blood vessels providing oxygenated blood to the brain. When plaque builds up in these blood vessels, it creates a blockage thereby making the blood unable to reach the brain. This condition is called carotid artery disease. When a significant amount of blood flow is cut to the brain, patients become susceptible to stroke. Thus, carotid artery surgery is aimed at removing such blockages for a steady supply of blood to the brain.

Recommended Reading: Hooded Eye Surgery Before And After

Preparing For Carotid Artery Surgery

In the days before the surgery, your doctor may want to conduct tests that will give them a better picture of your arteries. Tests used to prepare for a CEA include:

  • Carotid ultrasound.Sound waves are used to create a picture of the artery and measure the blood flow.
  • Carotid angiography. This invasive X-ray procedure uses dye to highlight the artery, making the blockages visible.
  • Magnetic resonance angiography . Magnetic and radio waves create a picture of the artery, sometimes with the use of contrast dye to get a clearer image.
  • Computed tomography angiography. X-rays provide a 3D picture of the arteries using dye as well.

Reduces Risk Of First Time Stroke

Carotid angioplasty and stenting

People who have not had a stroke or TIA can also see significant benefits from carotid endarterectomy surgery. For those who have never experienced stroke symptoms but who also have significant blockage in the carotid artery, surgery can reduce the risk of stroke by more than 50 percent, but so can medications, particularly newer medications designed to prevent neurovascular disease. It is important to consult with a neurosurgeon to determine what is the better option for you in this kind of a scenario.

Also Check: What Helps Leg Pain After Back Surgery

Surgery May Not Be Necessary

While some physicians and surgeons are quick to suggest surgery, if you have not had any symptoms, you may not need to do an extreme treatment. If, however, you have had a stroke or mini-stroke, then the surgery could help you prevent another stroke in the future. Also, if you have very blocked arteries, a surgeon will suggest the procedure.

However, if you have had no strokes or mini-strokes, then the procedure may not benefit you. There are other ways in which you can reduce a stroke without surgery including changing medications or lifestyle modifications.

Ideally, CEA should be reserved for patients who have:

  • Severely blocked arteries that have already caused strokes.
  • Moderate blockages that have led to mini-strokes.
  • Severe blockages that have not caused strokes, but the patient is 40 to 75 years of age and still has a relatively low risk of surgical complications.

How Do They Remove Plaque From The Carotid Artery

This procedure is known as a carotid endarterectomy. This technique is time-sensitive and should be performed as soon as possible after the stroke or TIA in order to prevent further stroke. A surgeon creates an incision in the neck just below the jaw during this treatment, then opens the carotid artery and gently eliminates the plaque. The surgeon monitors the nerve while it remains intact and avoids injuring it during removal of the plaque.

The carotid arteries are large vessels that supply blood to the head and brain. They can become blocked by plaque buildup: this is called atherosclerosis. When this happens, it can cause symptoms such as pain behind the head, face or temple when walking or chewing , loss of vision in one eye, confusion, trouble speaking or understanding speech, paralysis on one side of the body, dizziness, nausea, vomiting, fatigue, fever, chills, sweating, numbness or tingling in the arm, hand, or leg, or weakness or paralysis in the arm or leg. A person with these symptoms should call 911 immediately.

If the blockage affects only one carotid artery, the risk of a major stroke is high if surgery isn’t done quickly. If both carotids are blocked, the patient will likely suffer a major stroke whether or not surgery is done. After a stroke, doctors may want to consider performing this surgery to reduce the risk of another event.

Recommended Reading: Open Heart Surgery Recovery Time

What Happens During Surgery

Carotid endarterectomy surgery takes around an hour in a hospital setting and typically requires general anesthesia. Surgeons make an incision in the neck to expose the affected carotid artery. The arteries in the neck are then identified, and prepared for the incision. The area of the artery where the plaque is located is then opened up. The plaque lining the affected artery wall is peeled away, so that normal blood flow can resume. The artery is reconnected and the incision stitched closed. When an artery is severely blocked, doctors may also create a patch, using either synthetic material or a graft from an artery elsewhere in the body.

After the surgery, patients usually recover in the hospital for one or two days, where they can be monitored for complications. At home, recuperation typically takes two to three weeks and, without complications, patients can gradually return to normal activity levels during that time. Post-op follow-ups include general progress checks and imaging tests such as carotid ultrasound to monitor healing and check for restenosis a return of plaque.

Risks Of Having A Carotid Endarterectomy

Carotid artery disease  The dangerous build up and deadly let down

There are serious risks associated with having a carotid endarterectomy.

Potential life-threatening complications include:

Your doctor may give you anti-clotting medications before surgery to decrease your risk of stroke or blood clots.

Less serious complications associated with a carotid endarterectomy include:

  • Reaction to anesthesia

Also Check: Signs Of Infection After Surgery

Latest news
Related news