Carotid endarterectomy is a surgical procedure which is performed for the carotid artery that has narrowed because of deposition of plaque. Carotid artery is the major artery of the body which branches out to the Internal carotid artery (ICA) which supplies the oxygen rich blood to the brain and the External carotid artery (ECA) which supplies the oxygen rich blood to the face, scalp and neck. Carotid endarterectomy is done to remove fatty deposits (plaque) that are narrowing some very crucial neck arteries. These neck arteries are called the carotid arteries. They have a key role of supplying blood, oxygen and nutrients to your brain. If an atherosclerotic plaque or other fatty materials block an artery, it narrows or blocks the blood flow, and this could result in a stroke.
With the changing lifestyle, indulgence in habits like consumption of junk food, smoking and alcohol, there has been a gradual rise in the number of patients who are affected with endarteritis which in turn leads to the reduction of flow of blood to the brain and the peripheral organs leading to a condition called as Stroke. Stroke is one the initial symptoms of damage to the brain leading to paralysis. Hence, it is essential to treat stroke at the earliest to prevent long term brain damage.
What are the symptoms of Stroke or Transient Ischaemic attack (TIA)?
Stroke as mentioned earlier is the primary signs of reduced blood supply to the brain which can lead to further serious complications. Occasionally a stroke does not manifest clinically and occurs for a shorter period of time hence is called as the Transient Ischaemic attack or Mini-Stroke. The symptoms that could lead to a diagnosis of a stroke and a mini stroke include ;
- Headache
- Loss of balance
- Difficulty in moving the limbs
- Blurred or disturbed vision
- Difficulty in speech
- Numbness on either one side or both sides of the face
If any of the above mentioned symptoms are encountered it is essential to seek urgent medical help to avoid any serious complications.
Occasionally a mini stroke may lead to occurrence of a full blown stroke in a span of days, weeks or months. Hence milder symptoms should not be ignored and it is advised to seek urgent medical care.
What are the indications for carotid endarterectomy surgery ?
If you have had one or more tests that prove there is blockage, then that is a definite indication for carotid endarterectomy surgery. If you are suffering from transient ischemic attacks (TIAs),that is also an indication. Though TIAs are transient, they serve as warning signs of a major stroke that may follow soon. Carotid endarterectomy surgery will stop the transient attacks from happening as well as reduce your risk for stroke. A carotid artery disease can occur as a result of the below mentioned causes.
- Increased levels of cholesterol (increased LDL and reduced LDL or if the ratio is disturbed)
- Long standing high blood pressure
- History of diabetes or insulin resistance
- History of coronary artery disease
- Smoking
- Alcoholism
How is a carotid artery disease diagnosed?
If you are experiencing any of the above mentioned symptoms, consultation with your general physician or a specialist is advised. The consultant specialist in turn will do a complete general physical examination and analysis of your symptoms and would advise for diagnostic tests to confirm the diagnosis. The diagnostic tests include Carotid duplex ultrasonography (80-97 % accuracy), carotid ultrasonography, magnetic resonance angiography, computerized tomography angiography or catheter based angiography. Once the required diagnostic tests are done and a confirmatory diagnosis of carotid endarteritis is confirmed the consulting specialist would refer you to a cardiologist or a vascular surgeon for further evaluation and treatment planning.
The treatment of stroke should not be delayed and has better outcome when the symptoms are treated within two weeks of any stroke or mini stroke related symptoms. Ask your consulting specialist for the treatment options, the risks and benefits of getting a carotid endarterectomy procedure done before deciding for the procedure.
How is carotid endarterectomy surgery done ?
After the administration of anaesthesia the operating surgeon places a 7-10cm incision from the corbner of the mouth to the breast bone to expose the carotid artery. The narrowed section of the carotid artery is approached and the plaque narrowing the artery is removed. The artery is either stitched back or closed with the help of a patch. Post surgically the patient is monitored in the surgical intensive care unit to avoid any complications and usually if the recovery is faster the patient is discharged within 2-3 days after the procedure. Ask your consulting specialist about at home care, medications to be taken and post-operative instructions to avoid any complications.
Is the procedure of Carotid Endarterectomy performed under anaesthesia?
Yes, the procedure of carotid endarterectomy is performed majorly under the influence of general anaesthesia and occasionally under local anaesthesia.
What about the after-effects of the carotid endarterectomy surgery ?
Initially, there will be the recovery period from anesthesia in which you’ll wake up in the hospital and may feel confused. There will be pain in your neck for the first couple of days. The hospital stay might include a day or two.
What are the risks or complications associated with a Carotid Endarterectomy procedure?
The carotid endarterectomy procedure is a major procedure hence the complications related to administration of general anaesthesia and the surgical procedure itself may range from nausea, vomiting, headache, stomach upset to bleeding, clot formation and infection at the site of the surgery. Other complications related to the procedure itself could be ;
- Hypotension (reduced blood pressure)
- Hypertension (elevated blood pressure)
- False aneurysm
- Cranial nerve dysfunction
- Injury to the vague nerve, hypoglossal nerve and the glossopharyngeal nerve and branches of the facial nerve
- Injury to the jugular vein (runs parallel to the carotid artery)
- Cerebral hyper perfusion and haemorrhage
What care do you need to take after the carotid endarterectomy surgery ?
The surgical procedure however, still requires a dedicated change in lifestyle and rehabilitative exercises to help recover fully. Healthy lifestyle changes will also help you reduce the chance of new atherosclerotic plaque deposits and decrease any risk of stroke.
Carotid endarterectomy procedure is one of the most common procedures performed for patients who are affected with stroke or mini stroke like symptoms. The success rates of the procedure are well documented in literature. An alternative choice for a carotid endarterectomy procedure is a procedure called as carotid artery stent placement. Ask you consulting specialist for the treatment options suitable for you. Post operatively it is essentially to maintain a healthy lifestyle by eating right, maintain your weight, regular exercising and cessation of habits like smoking and drinking alcohol as they may interfere with the outcome of the procedure.
How to find and reach vascular surgeons for carotid endarterectomy surgery ?
Now you can find and reach vascular surgeons from different hospitals and destinations on a single platform, Hinfoways. You can avail opinions and information from multiple vascular surgeons, get cost estimate for carotid endarterectomy surgery from different hospitals, compare things and then choose a vascular surgeon for carotid endarterectomy surgery.
Find, reach and choose a vascular surgeon for carotid endarterectomy surgery on Hinfoways. Make an informed choice.
Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
