Carotid Artery Surgery is a procedure done to clear fat content called plaque blocking the flow of blood to the brain.
The carotid arteries supply blood to your brain, face, and neck. When these arteries are being blocked, especially, the supply to the brain, it could cause a stroke.
The Carotid Arteries
The Carotid Arteries are the body’s major blood vessels. It is responsible for supplying blood to your brain, neck, and face. There are two of them, the left carotid artery and the right carotid artery. The one located on your neck is divided into two. And each artery has distinct roles:
- External Carotid Artery is responsible for the blood supplied to the neck and face.
- The Internal Carotid Artery is responsible for the blood supplied to the brain.
The Carotid Artery is composed of three layers: Adventitia (outer), Media (middle), and Intima (inner).
Located at the intersection of the internal and external artery is the Carotid Sinus. This branch has sensors that help maintain regular blood pressure. You can feel its pulse by pressing your fingertips against the side of your windpipe.
Carotid Artery Surgery
Carotid Artery Surgery or Carotid Endarterectomy is a procedure especially done to treat stroke. Diseases related to the carotid artery becomes common as we age. This happens when a fatty substance called plaque, a build-up in one of the arteries that clog the flow of blood to your brain. Through surgery, the plaque is removed, enabling normal blood circulation and reduces the risk of stroke.
Stroke disrupts the supply of oxygen to the brain. If unable to give immediate medical attention, within minutes, brain cells will start to die. Stroke is one of the most common deaths in the world and the leading cause of disability in the United States.
During the procedure:
- The patient will receive general anesthesia. There are hospitals that use local anesthesia instead and applies to the area of operation only. Anesthetics allow the patient to sleep and numb the pain. In addition, patients are also handed medications to help them feel relaxed
- A surgical procedure is done on an operating table. Usually, patients are usually turned to one side where the blocked artery faces up.
- The surgeon makes an incision on your neck. A tube called catheter is placed over your artery, allowing blood circulation during the procedure.
- The affected carotid artery is opened. And the surgeon removes the plaque clogging your artery.
- Then, the surgeon stitches the artery.
- After the operation, they will monitor you closely for development.
The operation usually takes about 2 hours.
There are another technique surgeons used called eversion carotid endarterectomy. Where they will cut the artery, turn it inside out then remove the plaque. After the plaque is removed, the surgeon re-attaches the artery.
There are times that surgical procedure is not needed. Patients may or may not have the symptoms. And there are other factors to be considered other than the degree of blockage in the artery.
Your doctor will have to evaluate your condition to determine whether you are a candidate for an operation. However, doctors may recommend the surgical procedure if the disease is now causing severe narrowing in the artery.
If carotid endarterectomy isn’t recommended by your doctor or it’s too risky to perform, other procedures are as follows:
- Carotid Angioplasty – A tiny inflatable balloon is temporarily inserted into the affected artery. When the tiny balloon is inflated, it will widen the area, allowing the blood to flow freely to your brain.
- Stenting – Often combined with carotid angioplasty. This procedure involves placing a small metal coil called a stent to the affected artery. The stent helps the artery from narrowing.
As with any surgical procedure, Carotid Artery Surgery has its risk and potential complications.
The minimal risk may be expected in the hands of a seasoned doctor but it may also vary on the severity of the carotid artery disease, position of the blockage, history of stroke and other existing medical condition.
As follows are the common risks of undergoing this surgery:
This procedure supposed to treat stroke but it may also possess the risk of artery blockage during the early postoperative period. It happens if blood clots are formed. To prevent this from happening, the surgeon places a shunt to redirect the flow of blood to your brain. They may also prescribe anticoagulant before surgery to decrease the chances of a blood clot.
Stress is common to a patient about to undergo surgery. It also causes stress to the heart that may lead to a heart attack. To prevent this from happening, your medical team will closely monitor your condition through the entire procedure and during your recovery period. They will monitor your blood pressure and heart rate. If they noticed anything abnormal, your doctor will take proper precautionary measures to remedy the problem.
During the procedure, there is a risk of nerve damage. Nerves connected to your voice box, tongue, and movement of the neck; either causing temporary or permanent damage to the nerves. Restoring damaged nerves are possible and may regain function of the nerves through rehabilitation and help of physical therapy.
Redevelopment of the Plaque
Plaques can redevelop and even create new clogs within the arteries. Committing to a change in lifestyle and following doctor’s advice is the best way to reduce the risk of plaque redevelopment.
After the operation, usually, the patient will be moved to the recovery section of the operating area, or intensive care unit (ICU).
ICU is a specialized unit for patients who needs to be closely monitored after surgery. Blood pressure and heart rate are monitored to ensure recovery.
Patients are usually given painkillers because they may experience discomfort around their neck area where the incision was made. They may also feel numbness on the wound but it should disappear within a few hours.
A few hours after the surgery the patient should be able to eat and drink by then and be able to return home after 48 hours at the recommendation of your doctor.
Usually, the patient can resume his normal activities after three to four weeks. During your recovery period, your doctor’s will still monitor you throughout the entire period for any progress.
Enlisted below are a few reminders to keep in mind during your recovery:
- Soreness around the neck area may last about two weeks.
- You may need support to some of your daily routines. You must be with someone at all times.
- Driving is not advisable. Driving requires head movement that may complicate the incision wounds.
- After four weeks, you may still feel numbness along your jaw area and near your earlobes. It may last 6 months to 12 months.