Skip links
How Can We Help?

Search for answers or browse our knowledge base.

Documentation | Demos | Support

< All Topics
Print

Carotid Endarterectomy

What is the problem? Many people suffer a stroke (“CVA”) or have warning signs of a stroke (a “mini stroke” or “TIA”) and are then at a higher risk of having another perhaps major or fatal stroke. All patients with an increased risk of stroke receive medical treatment plus advice to lower this risk. This includes avoiding tobacco plus treatment of   diabetes, high blood pressure, high cholesterol and heart disease; in addition, a statin (to lower cholesterol) and Aspirin are usually prescribed. However, in many cases, surgical treatment is also recommended. In such patients, like yourself, there is narrowing of a main artery in your neck (carotid artery) that supplies blood to the brain. This is due to hardening of the arteries (atherosclerosis) where our arteries become furred up with cholesterol reducing the flow of blood. It is important to realize that the left side of the brain looks after the right side of the body and vice versa. The intended benefit of this operation is

What is the problem? Many people suffer a stroke (“CVA”) or have warning signs of a stroke (a “mini stroke” or “TIA”) and are then at a higher risk of having another perhaps major or fatal stroke. All patients with an increased risk of stroke receive medical treatment plus advice to lower this risk. This includes avoiding tobacco plus treatment of   diabetes, high blood pressure, high cholesterol and heart disease; in addition, a statin (to lower cholesterol) and Aspirin are usually prescribed. However, in many cases, surgical treatment is also recommended. In such patients, like yourself, there is narrowing of a main artery in your neck (carotid artery) that supplies blood to the brain. This is due to hardening of the arteries (atherosclerosis) where our arteries become furred up with cholesterol reducing the flow of blood. It is important to realize that the left side of the brain looks after the right side of the body and vice versa. The intended benefit of this operation is to reduce your change of a further stroke because we know that the narrowed artery makes your chances of suffering stroke much higher than normal. We also know this operation to correct the narrowing; called carotid endarterectomy will lower your overall chance of stroke significantly.

Before the operation: you are usually admitted to hospital a day before surgery, and for just one or two days after, by a nurse and doctor who will explain the ward routines and note your personal details. Before the operation, you are seen by the anaesthetist and by the surgeon who will explain anything that you are not sure about and who will ask you to sign the Consent form, please feel free to ask questions. There may be more blood tests and X-rays or scans. You should always take your normal medicines as usual and sometimes before the operation you may have a sedative. You will be asked to eat absolutely nothing after midnight and not to drink for two hours before the operation. If you fell unable to sleep, please ask the doctor to prescribe a sleeping tablet to allow you plenty of rest.

The operation: you are first taken to the theatre reception and then to the anaesthetic room where you are put to sleep or local anaesthetic given, as you choose. A cut is made on the neck to expose the carotid artery which is then clamped off and opened. A plastic tube (shunt) is inserted to allow blood to flow to the brain while the diseased lining of the artery is removed. The shunt is then removed and the artery is stitched closed, incorporating a special fabric path (made of Dracon) which widens the artery, to discourage future narrowing and stroke. The skin wound is closed with a buried dissolving stitch and a drainage tube is inserted to remove any blood that leaks from the artery.

After the operation: you are taken to the Recovery area of Theatre or to Intensive Care for careful observation before returning to your own ward. You will have a drip in your arm to provide fluid and to monitor blood pressure and also a tube to drain urine from your bladder (catheter). You are allowed to drink and eat after you have woken up completely. The surgery is not particularly painful though you may need some painkillers which are given if required; you may have a sore throat. On the day after surgery you are allowed out of bed. The drip and drainage tube are removed next day or so when no longer needed and you are allowed home as soon as well enough, usually next day.

Are there any risks? Some oozing and minor bruising around the wound is common and occasionally takes some weeks to settle down. Sometimes a blood transfusion is necessary although this is uncommon. There is usually a numb area on the side of the neck and ear that may improve over several months or is sometimes permanent. Temporary weakness of the side of the mouth or tongue occurs uncommonly though it is only very rarely permanent. Heart or chest problems can sometimes occur as patients with this condition are commonly smokers. There is a small risk of developing a stroke during the operation and a very small risk of death-this combined risk is less than 4%. However, you are more likely to avoid a major stroke with surgery. You may wish to discuss these risks with your Surgeon in more detail before the operation. It may take a week or more to fully recover; no driving for two weeks.

Are there any alternative treatments? You will already be receiving medical treatment, unfortunately, this does not reduce the risk of stroke like surgery. Recently a new treatment called angioplasty is being tried in X-ray, a balloon is introduced through a needle into the artery and inflated inside the narrowing to widen the channel through the artery. It is too early to say if this treatment will be successful in the long term.

What about afterwards? You will usually not need an appointment in the outpatient clinic but can be seen if required. The operation usually gives good long-term relief. You can also help by improving your general health by taking regular exercise and reducing the amount of fat in your diet. You must not smoke and should continue taking the Aspirin and statin for life. All these things will help reduce the chances of further trouble from arterial diseases including stroke and heart attack. Some patients may need to have treatment for narrowing of the artery on both sides. because we know that the narrowed artery makes your chances of suffering stroke much higher than normal. We also know this operation to correct the narrowing; called carotid endarterectomy will lower your overall chance of stroke significantly.

Before the operation: you are usually admitted to hospital a day before surgery, and for just one or two days after, by a nurse and doctor who will explain the ward routines and note your personal details. Before the operation, you are seen by the anaesthetist and by the surgeon who will explain anything that you are not sure about and who will ask you to sign the Consent form, please feel free to ask questions. There may be more blood tests and X-rays or scans. You should always take your normal medicines as usual and sometimes before the operation you may have a sedative. You will be asked to eat absolutely nothing after midnight and not to drink for two hours before the operation. If you fell unable to sleep, please ask the doctor to prescribe a sleeping tablet to allow you plenty of rest.

The operation: you are first taken to the theatre reception and then to the anaesthetic room where you are put to sleep or local anaesthetic given, as you choose. A cut is made on the neck to expose the carotid artery which is then clamped off and opened. A plastic tube (shunt) is inserted to allow blood to flow to the brain while the diseased lining of the artery is removed. The shunt is then removed and the artery is stitched closed, incorporating a special fabric path (made of Dracon) which widens the artery, to discourage future narrowing and stroke. The skin wound is closed with a buried dissolving stitch and a drainage tube is inserted to remove any blood that leaks from the artery.

After the operation: you are taken to the Recovery area of Theatre or to Intensive Care for careful observation before returning to your own ward. You will have a drip in your arm to provide fluid and to monitor blood pressure and also a tube to drain urine from your bladder (catheter). You are allowed to drink and eat after you have woken up completely. The surgery is not particularly painful though you may need some painkillers which are given if required; you may have a sore throat. On the day after surgery you are allowed out of bed. The drip and drainage tube are removed next day or so when no longer needed and you are allowed home as soon as well enough, usually next day.

Are there any risks? Some oozing and minor bruising around the wound is common and occasionally takes some weeks to settle down. Sometimes a blood transfusion is necessary although this is uncommon. There is usually a numb area on the side of the neck and ear that may improve over several months or is sometimes permanent. Temporary weakness of the side of the mouth or tongue occurs uncommonly though it is only very rarely permanent. Heart or chest problems can sometimes occur as patients with this condition are commonly smokers. There is a small risk of developing a stroke during the operation and a very small risk of death-this combined risk is less than 4%. However, you are more likely to avoid a major stroke with surgery. You may wish to discuss these risks with your Surgeon in more detail before the operation. It may take a week or more to fully recover; no driving for two weeks.

Are there any alternative treatments? You will already be receiving medical treatment, unfortunately, this does not reduce the risk of stroke like surgery. Recently a new treatment called angioplasty is being tried in X-ray, a balloon is introduced through a needle into the artery and inflated inside the narrowing to widen the channel through the artery. It is too early to say if this treatment will be successful in the long term.

What about afterwards? You will usually not need an appointment in the outpatient clinic but can be seen if required. The operation usually gives good long-term relief. You can also help by improving your general health by taking regular exercise and reducing the amount of fat in your diet. You must not smoke and should continue taking the Aspirin and statin for life. All these things will help reduce the chances of further trouble from arterial diseases including stroke and heart attack. Some patients may need to have treatment for narrowing of the artery on both sides.

Table of Contents
Αυτός ο ιστότοπος χρησιμοποιεί cookies για να βελτιώσει την εμπειρία σας στον ιστό.
Explore
Drag