Carotid Endarterectomy

Carotid endarterectomy is a surgical procedure used to treat diseases related to the carotid artery. These carotid artery diseases are caused due to deposition of the waxy and fatty materials in the carotid artery. This deposition, also known as atherosclerosis, reduces blood flow to the brain. Removing the plaque reduces the risk of stroke by improving blood flow to the brain. As a result, the patients may not experience symptoms. The surgeon decides the candidature of the patient for carotid endarterectomy by determining the severity of blockage in the carotid artery. In cases where carotid endarterectomy is not required, the doctor may recommend other techniques to manage the blocked carotid artery. 

 

1. Endovascular endarterectomy is recommended by the doctor if there is a blockage in the artery of the neck known as the carotid artery. 
2. It is used to clear the fatty material from the carotid artery in case of stroke or transient ischaemic attack.
3. You may not experience any kind of symptom if you have carotid artery disease until the blockage is higher.

The benefit of carotid endarterectomy in symptomatic carotid stenosis is greatest when done within 14 days of the symptoms. If the surgery of endovascular endarterectomy is delayed, then the patient may experience some complications like:-

1. Stroke leading to disability and death.
2. Plaque rupture that may result in blocking smaller arteries.
3. Blockage due to the formation of a large clot.

1. First of all, an anesthesiologist will inject a precise dose of general anaesthesia.
2. The neck will be cleaned using an antibiotic solution to prevent any chances of infection.
3. Then after some time, the doctor will start the procedure by making a small cut into the artery in which there is a blockage.
4. Once the carotid artery has been accessed, the surgeon will then clamp the artery to stop the flow of blood. After making an opening, the shunt is inserted into the carotid artery.
5. The surgeon will remove the inner layer and the fatty materials deposited in the narrowed blood vessel along with the shunt.
6. The blood vessels are closed either using a suture or a special patch. The use of patches or stitches depends upon the preference of the doctor.
7. A small drainage tube may be left at the wound site to drain any fluid that might form after the surgery. It is generally removed after a few days of the surgery.
8. The doctor bandages the wound after ensuring that there is no bleeding.

1. The doctor will provide detailed information to you about the surgical procedure. 
2. The patient will be asked to sign a consent form before getting ready for the surgery. 
3. Staff from the hospital will examine the medical history of the patient along with the blood test. They will also do a physical examination of the patient to ensure the good health of the patient.
4. Inform your doctor about the medications you are taking, especially if you are taking some blood-thinning medicines like aspirin and warfarin.
5. Do not eat after midnight before the day of surgery. 
6. If you have a pacemaker installed, you should talk to your doctor.

1. Try to reach the hospital premise before the scheduled time for the surgery. For example, try to reach at least 2 hours before the scheduled time.
2. Leave all the valuables at home.
3. Always wear loose-fitting and comfortable clothes to the hospital.
4. After reaching the hospital, the staff will ask you some questions like name, father's name and address. Then, it is done to confirm the candidate for the surgery.
5. Then the staff will ask you to change into a surgery gown. 
6. Then they will check all the vital signs like blood pressure and heart rate before going to the operation theatre.
7. An intravenous line is inserted into the blood vessel, and you will be wheeled to the operation theatre for surgery.

1. The surgery takes about a few hours and is done at a hospital.
2. The whole procedure is done under the influence of general or local anaesthesia. Therefore, the patient will not experience any kind of pain during the surgery.
3. The selection of the anaesthesia depends upon the preference of the doctor. For example, if the doctors want to check the brain activity during the surgery, they might use local anaesthesia.
4. All the vital signs like heart rate, pulse rate, and blood pressure of the patient are monitored continuously during the surgery. 

1. After completing the surgery, you will be shifted to the recovery room.
2. Their staff will continuously monitor your heart rate and blood pressure until you wake up.
3. If any drainage pipe is placed, it will get removed the next morning.
4. Generally, you will be discharged the next day or two days after the surgery. 
5. You may experience neck pain for about two weeks after the surgery. 
6. The doctor will prescribe you some pain killer medicines to ease the pain after the surgery. 
7. You will also receive the medicines to lower your blood pressure after the surgery.
8. Try to not wet the wound because it may lead to increased chances of infection.
9. You will receive special bathing instructions from the doctor to prevent the stitches from getting damaged.
10. It is advised to take a low-fat diet.

First Follow-Up Appointment

1. Your doctor may ask you to visit the hospital for follow-up after 1 to 3 weeks of the surgery. It is time to check if everything is going smoothly after the surgery. 
2. At the follow-up appointment, the doctor will examine the sutures.
3. The sutures are generally removed within 7-10 days after the surgery. 
4. A neck ultrasound may also be performed at the follow-up. It is done to check the internal healing of the condition and if there is any re-occurrence of the treated condition. 
5. If the ultrasound results are satisfactory, the next ultrasound will be performed after six months of the surgery. 

Do not hesitate or delay in calling your doctor if you are experiencing any of the following symptoms:

1. Fever accompanied by chills
2. Swelling in legs
3. Shortness of breath
4. Weakness in the body
5. Pain in the chest
6. Having trouble swallowing
7. Headache
8. Confusion and having difficulty in communication.
9. Dizziness
10. Slurred speech
11. Feeling of tingling or loss of feeling on the one side of the face.
12. Drainage of pus from the site of the incision.