Currently, carotid surgeries are very effective method of treatment. Two large arteries are located in the anterior part of the neck. These are the carotid arteries and carry blood to the brain. If one is blocked, it can cause paralysis. Surgery to clear a blocked artery is called carotid endarterectomy (CEA) If the carotid artery is severely blocked and has already caused a stroke or mini-stroke, surgery can greatly reduce the risk of another stroke.
Carotid surgeries can also help if there is moderate obstruction, but immediately after a stroke or mini-stroke, if a stroke or mini-stroke has occurred. The risk of complications from surgery is low if there are severe blockages, but no paralysis or mini-paralysis has occurred, and the person is between 40 and 75 years old. If surgery is required, surgeons make sure that there is a low complication rate for people who do not have symptoms. The rate should be less than 3 percent.
What are Carotid Surgeries?
Located on both sides of the neck, carotid arteries provide the face and brain with the oxygen-rich blood they need to function properly. Without this blood flow, brain cells die. When blood flow to an area of the brain is restricted or blocked, it can cause paralysis. Strokes can cause temporary or permanent mental and physical disorders, and can also be fatal.
Carotid surgeries are effective for those who have carotid artery disease. A substance called plaque, consisting of compounds such as fat, cholesterol, and calcium, accumulates in the carotid artery and narrows the artery. This narrowing is called stenosis and can restrict blood flow. Parts of this plaque can rupture and go to a smaller artery in the brain. If this happens, it can cause an embolism. If the narrowing is significant enough, it can completely cut off the blood supply to the brain and cause paralysis.
Carotid surgery, called carotid endarterectomy (CEA) is a way to clear blockages in normal blood flow and minimize your risk of stroke. Another name for the CEA is carotid artery surgery
Which Department Deals with the Carotid Surgeries?
The carotid surgeries are handled by the cardiology department. These surgeries take about an hour in a hospital setting and usually require general anesthesia. Surgeons make an incision in the neck to expose the affected carotid artery. Then the arteries in the neck are identified and prepared for the incision. Then the area where the plaque is located is opened. The plaque that covers the affected artery wall is peeled off so that normal blood flow can continue. The artery is reconnected and the incision is sutured and closed.
Carotid artery disease can cause paralysis. These blockages can be caused by plaque or a blood clot that blocks the artery. Carotid surgeries, helps blood flow to the brain to prevent strokes. Carotid artery surgery also helps prevent a transient ischemic attack (TIA). A lethargy has symptoms of paralysis, such as difficulty speaking or seeing, and difficulty walking, but these persist for a short time. The doctor may recommend CEA to patients who meet certain criteria, such as:
- If you have already had a stroke
- If you already have a TIA
- Obstruction of the carotid artery is severe, but not complete
How Are Carotid Surgeries Performed?
In the days before surgery, the doctor may want to take tests that will give a better picture of the arteries. These tests include:
- Carotid ultrasound
- Sound waves
- Carotid angiography
- Magnetic resonance angiography (MRA)
- Computed tomography angiography
Carotid ultrasound, that is, sound waves, is used to create a picture of the artery and measure blood flow. Carotid angiography, that is, the invasive X-ray procedure, uses dye to highlight the artery, making blockages visible.
Magnetic resonance angiography (MRA), or magnetic radio waves, sometimes create a picture of the artery with the use of contrast paint to obtain a clearer image. Angiography on computed tomography X-rays also provide a 3-dimensional picture of the arteries using a dye.
Carotid surgeries are performed in a hospital and usually takes several hours. In this procedure, the surgeon cuts the artery and removes the blockage. Although there is only local anesthesia that numbs a certain part of the neck, a general anesthesia is usually taken.
If the surgeon wants to check the neurological status during the procedure to see how the brain reacts, he may decide to use local anesthesia. The cleared artery is clamped during the operation, but the blood still reaches the brain through the carotid artery on the other side of the neck.
A tube can also be used to redirect blood flow around the artery receiving surgery. After the blockage is removed, the artery is sutured or reassembled. The clamp is opened, and the opening in the neck is closed with stitches. It may be necessary to have a drain on the neck to remove the formed liquid.
The surgeon should be talked about the different patch materials. The patient's saphenous vein can be used as a patch. In this case, there will be a second incision on the leg.
What are the Advantages of Carotid Surgeries?
A carotid endarterectomy improves blood flow to the brain by removing the accumulation of plaque (fat and cholesterol) inside the carotid artery. This can help prevent a person who has already had a stroke from having another stroke. The advantages of carotid endarterectomy are:
- Reduces the Risk of October Stroke
- Reduces the Risk of the First Stroke
Carotid endarterectomy surgery can reduce the risk of stroke by up to 80 percent in people at the highest risk. This includes people who have previously had at least one stroke or attack and have a severe occlusion of the carotid artery. Drug therapy and lifestyle changes for these patients may not be effective in reducing plaque deposits in the arteries.
People who have not had a stroke or attack can also see significant benefits from carotid endarterectomy surgery. For people who have never experienced symptoms of stroke but also have a significant blockage in the carotid artery, surgery can reduce the risk of stroke by more than 50 percent, but there may also be newer drugs that are specifically designed to prevent neurovascular. In this type of scenario, it is important to consult a neurosurgeon in determining which is the best option for the patient.
The Process After Carotid Surgeries
After carotid surgeries,the recovery period changes, and the patient needs to stay overnight in the hospital for monitoring. The doctor will want to make sure that there is no bleeding, poor blood flow to the brain, or other possible stroke risk factors. Most patients go home within 24 hours after surgery.
There may be some pain, numbness, swelling and bruising in the neck, or the patient may have difficulty swallowing. The doctor may prescribe painkillers to the patient. The surgeon will probably ask to avoid heavy lifting and driving for 1 to 2 weeks.
CEA is considered a reasonably safe procedure that can greatly reduce the risk of stroke if there is carotid artery disease. The procedure carries a small risk of stroke, nerve damage and even death. Other diseases, such as heart disease or diabetes, can also complicate any surgical procedure. It is important that the options are thoroughly discussed with the doctor before deciding on this procedure.
A carotid stent is another surgical alternative to a CEA. During this procedure, a thin metal tube called a stent is inserted into the artery and the tube is inflated with a balloon to keep the artery open. The inflated balloon pulls the plaque deposit out of the way, reopening the path. The stent is designed to prevent the road from clogging in the future. This procedure carries different risks, including a higher risk of stroke, and is usually reserved for certain conditions.