The carotid arteries are blood vessels located on each side of your neck that supplies blood to the brain. Sometimes, fatty, waxy deposits build up in one of the carotid arteries which lead to Carotid artery disease also called Atherosclerosis. In this condition, arteries are narrowed which interrupts in normal blood flow and may lead to risk of stroke.
Carotid endarterectomy is a procedure to treat carotid artery disease by removing the plaques and thus improving the blood flow and prevent any future strokes. Carotid endarterectomy (CEA) may be recommended for patients who have had a transient ischemic attack (TIA) or a mild stroke due to significant carotid artery disease.
PREPARING FOR THE SURGERY
A few days before the procedure, pre-procedure tests may be performed to ensure that it is safe to perform the surgery. Your surgeon may order a cerebral angiogram to better define your brain anatomy and CT angiography to obtain information regarding your carotid arteries and your brain. Detailed physical examination and past history will be studies, you may be advised to discontinue certain medications before the procedure.
ON THE DAY OF THE SURGERY
A Carotid endarterectomy is done under general anaesthesia means you are asleep during the procedure or in some cases it is done under regional anaesthesia in which area to be operated upon is numbed while you are awake and relaxed during the procedure. The surgeon makes an incision in the neck at the site of the blockage and temporarily reroute blood flow around the blockage or narrowing and isolate the area. The surgeon then makes a length-wise incision along the portion of the artery containing the plaque. The plaque is removed and the defect closed using a patch of material to widen the artery and prevent narrowing from occurring again. Blood flow to the brain is restored through its normal path. Surgery lasts for about 2-3 hours.
You will be kept in recovery room for observation and check for any signs of bleeding, stroke, or poor blood flow to your brain and you will be discharged after a day of hospitalization. You will have a sore throat and the skin around the incision on your neck will be numb, this will improve over time. You may feel postoperative neck pain which will be managed by over-the-counter medications. You may have a drain in your neck that goes into your incision. It will drain fluid that builds up in the area and it will be removed within a day. You will be kept on soft diet for a while before returning to normal diet.
For most people, Carotid Endarterectomy helps prevent further brain damage and reduces the risk of stroke and recovery from the procedure is rapid. Most people are able to return to work three to four weeks after having a carotid endarterectomy. But you will need to make lifestyle changes to help prevent plaque build-up, blood clots, and other problems in your carotid arteries over time. You may be advised to limit physical activity for a few weeks after having surgery. Moving around soon after surgery will help speed up your recovery and prevent complications. You will be provided with a diet routine and a light exercise program such as deep breathing and coughing to help you recover faster. It is recommended to quit smoking to prevent any future risks.
However, unless you adopt a healthier lifestyle, plaque build-up, clot formation and other problems in the carotid arteries can return.
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Q: How a blockage in carotid artery is determined?
A: Sometimes symptoms are not very significant, common symptoms include: A sudden, severe headache with no known cause, Dizziness or loss of balance, Inability to move one or more of your limbs, Sudden trouble seeing in one or both eyes, Sudden weakness or numbness in the face or limbs.
Q: What are the chances of stroke after Carotid Endarterectomy surgery?
A: For patients under 75 years of age with asymptomatic carotid artery disease, carotid endarterectomy reduces the risk of future stroke by 46 % and in other cases it depends on various risk factors and the percentage of artery being narrowed.
Q: What extent of Carotid artery narrowing requires carotid endarterectomy surgery?
A: Carotid endarterectomy should be strongly considered for symptomatic patients with 70 to 99 percent blockage in the carotid artery. It also should be considered for those with 50 to 69 percent stenosis.
Q: How painful is the Carotid endarterectomy surgery?
A: The cut in your neck is likely to be uncomfortable at first so you’ll be offered pain relief. The pain should improve, but you may get twinges and aches for between three to four weeks. It’s important your pain is controlled so that you can move about.
Q: When can I join back my work?
A: Most people are able to go back to work after six weeks. If you need further time off, consult with your cardiologist.
Q: When can I drive after the Carotid endarterectomy surgery?
A: After surgery you can start driving again when you’re able move your neck freely and look over your shoulder to get a clear view of the road. If this causes you pain, then you are not ready to drive. This can sometimes take six weeks or so after your operation.
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