The carotid artery is what responsible for delivering blood in your face and brain. Two of which can be found on each side of your neck.
There are cases wherein the carotid artery is blocked by plaque – any fatty material that would hinder the blood flow. The blockage is crucial as it can stop the blood flow to the brain by gradually decreasing the blood supply, leading it to stroke. And stroke can make someone mentally and physically impaired, may it be temporary or permanent. It is also fatal.
This is where the carotid artery surgery comes in. The surgery is important for restoring the normal blood flow in the carotid artery as well as for enough blood supplication to the face and brain.
What is carotid artery surgery?
The carotid artery surgery has two kinds, namely endarterectomy and angioplasty with stent placement. The latter surgery is, however, associated with the supplication of blood to the heart. So, in this article, we will focus only on carotid endarterectomy.
Additional trivia. Endarterectomy surgery has many alternative names such as Endarterectomy – carotid artery, carotid artery stenosis – surgery, CAS surgery, and carotid endarterectomy.
This surgery usually takes 2 hours to perform. Once the procedure has ended, the patient’s personal doctor will make a test to check if the artery has been opened.
- During the procedure of endarterectomy, the patient will rest on a table inside the operating room. The affected side of the face will be turned toward the surgeons so they can work on the blocked carotid artery.
- General anesthesia will be injected to the patient so he/she can be free from any pain. But this is not the case in all hospitals. Some hospitals inject anesthesia on the part to be operated so the patient will be relaxed.
- Once the anesthesia takes effect, the surgeon will make an incision to the patient’s neck over the carotid artery. To make sure the patient’s blood flow won’t stop, a catheter (flexible tube) will be put around the area of the blocked artery.
- Setting the catheter and checking your heart activity, the surgeon will take away the plaque from within the artery. Once it is removed, the surgeon will stitch the incision and the blood flow toward the brain is now back to normal.
Risk of the Carotid Endarterectomy
As much as safe and helpful the surgery might be, there are still risk intertwined with it. That is why the series of tests before the actual operation is vital.
For instance, the doctor will need to see first how much space in the carotid artery is blocked. If it is blocked by more than 70 percent, surgery is needed to perform.
However, there are instances where the patient had a history of temporary brain injury or stroke. In these cases, the surgery might not be safe, thus, the patient’s doctor has to consider if he/she will do the surgery. If not, there are other available treatments he/she can recommend such as:
- No treatment at all, but continues annual test and check up for the affected carotid artery.
- The doctor may advise the patient to lower his/her cholesterol through medication and diet.
- The doctor may also offer blood-thinning medication. For example, warfarin (Coumadin), dabigatran (Pradaxa), clopidogrel (Plavix), and aspirin. This is to reduce the risk of stroke.
Once the surgery persists, the risk of breathing problem, as well as other allergic reaction due to medicines or anaesthesia, can occur.
Similarly, the carotid surgery itself does have the risk such as infection, swelling near the airway, stroke, seizures, more carotid artery blockage over time, heart attack, brain damage, and blood clots.
Before the Surgery
Since the physical and medical test is important before proceeding to the surgery, here are some guidelines that a patient can follow.
The patient should provide all information regarding the medications he/she is taking. This does not limit medicines only but also herbs and supplements that are without a doctor’s prescription.
Why is this important?
Two weeks before the procedure:
- The patient might be asked by his/her health care provider to stop any blood-thinning medications including Naprosyn (Aleve, Naproxen), clopidogrel (Plavix), ibuprofen (Advil, Motrin), and aspirin.
- He/she can be asked by his/her doctor if he/she is allowed to take any medicine on the day of the procedure. If yes, which medicine can the patient take?
- Smoking should be quitted during this span.
- If the patient has been infected with any disease such as herpes, fever, flu, or cold, he/she should tell his/her doctor about it.
Additionally, any instructions regarding the time of drinking and eating before the surgery is important to follow.
What to Expect after the Surgery?
The patient will experience a drain around the incision area in the neck. But it will be removed on the same day.
The doctor may also ask the patient to stay in the hospital overnight so nurses can check for any possible bleeding as well as stroke and poor brain blood flow. Say that the operation is done early in the day, you may expect the doctor to allow his/her patient to go home the same day.
Carotid endarterectomy is safe carotid artery surgery, knowing that patient followed the doctor’s instruction before, during, and after the procedure. It is an effective procedure to reduce the chance of developing stroke. However, over time, a patient may build, for the second time, plaque in the carotid artery as well other problems such as blood clots.
To prevent these conditions from happening, a lifestyle change may require a patient. This includes working out and changing the diet. Exercise may be done if the patient’s doctor approved of it. In other words, if it is safe to the patients he or she may apply in an exercise program. On the other hand, changing of diet is vital to reduce the level of blood pressure.
If the patient is smoking, he or she should stop it as well. He or she can ask for the doctor’s guide in quitting his/her smoking habit.