Carotid Artery Surgery, sometimes called carotid endarterectomy (CEA), is a surgery conducted to remove carotid blockages and restore and normalize the flow of blood. It decreases the chances of stroke. The carotid arteries which are located on both sides of the neck, transport oxygen rich blood to the brain. If the blood flow to the brain is blocked, this condition may result in a stroke or the death of brain cells. The restriction of the blood flow to the brain is usually caused by the build up of plaque in the artery. These layers of plaque are usually composed of fat and cholesterol. If the said layers become significant enough to cause a blockage, then stroke can become inevitable.
Carotid Artery Surgery Uses
A Carotid Artery Surgery or CEA performed by a medical professional or physician is primarily to remove blockages in the artery caused by plaque or blood clots. These blockages, once removed, will then decrease the patient’s chance of developing and experiencing a stroke. Performing a carotied artery surgery can also address and prevent the transient ischemic attack (TIA). Transient Ischemic Attacks have symptoms similar to that of stroke such as numbness, trouble walking and difficulty speaking or seeing. The difference, however, is that Transient Ischemic Attacks (TIA) symptoms last for shorter periods of time compared to a stroke and usually disappears within an hour. A patient’s doctor may recommend a Carotid Artery Surgery if a patient has a severe blockage of the artery, has already had a stroke and has already had a transient ischemic attack (TIA).
Preparation for Carotid Artery Surgery
A patient about to undergo Carotid Artery Surgery may be required by his/her doctor to undergo a series of tests a few days before the actual surgery. These tests will help the doctor get a better understanding of the patient’s arteries. Listed below are the list of tests that are conducted in preparation for Carotied artery surgery:
- Carotid Ultrasound: Doctors can get an image of their patient’s arteries and the possible problems of the said arteries through the use of sound waves.
- Carotid Angiography: A Carotid angiography entails using a device similar to the Xray using some form of dye to highlight the blockages in the artery.
- Magnetic Resonance Angiography (MRA): Magnetic Resonance Angiography, sometimes simply called as MRA, can also capture an image of the artery and its possible blockages using radio waves and contrast dye.
- Computed tomography angiography: The computed tomography angiography is a form of three dimensional (3D) X-ray that can give a more detailed image of the arteries and its possible blockages.
Complications After Carotid Artery Surgery
After the Carotid Artery Sugery, there are a number of possible risk factors of developing some form of complicaton. Some of these complcations include:
- Pain or numbness in the wounded area where the surgical procedure was primarily conducted: While this pain may be temporary, some patients may still require the intake of painkillers to address the said complication.
- Bleeding at the Site of the Surgery Wound: During the first few days or a week after the surgery, the wound may still a tendency to bleed which should immediately be cleansed and disinfected to avoid further infection.
- Infection at the site of the surgical wound: Similar to the previous entry, proper hygiene and wound cleaning and maintenance should be observed by patients who recently underwent Carotid ArterySurgery to ensure that no infections occur during the recovery.
- Nerve Damage: Nerve damage after Carotid Artery Surgery is usually temporary and can go away within the month. This complication, however, can bring hoarseness of the voice, weakness and numbness of the face.
Risks Factors after Carotid Artery Surgery
The aforementioned complications can possibly have increased risk of occurrence based on some identified risk factors. Listed below are some of these risk factors:
- The patient’s age: Older patient’s have a higher risk of developing some of the complications of Carotid Artery Surgery.
- Patients who smoke: People who smoke may have an increased chance of experiencing complications due to having a weaker immune system and the presence of infectious toxins in the body.
- Patients who already experienced Transient Ischemic Attack (TIA): People who already had a Transient Ischemic Attack may have a higher risk of developing Carotid Artery Surgery complications. The overall risk of the complication though, would be based on the severity of the stroke, how well the patient recovered and how recently the Ischemic attack occurred.
- Patients with another carotid artery that is blocked: The complications listed above have a higher risk of occurring to patients who have their other carotid artery blocked as well.
- Patients with other Health Conditions: Individuals who recently underwent a Carotid Ischemic Surgery may have an increased risk for complications if they have other health conditions such as type 2 diabetes, cancer, heart disease and hypertension or high blood pressure.
Recovery after a Carotid Ischemic Surgery
Recovery after a carotid ischemic surgery can usually be achieved without any concerns or complications as long as certain steps and medical attention are conducted by both the patient and his/her medical partner or physician. Patients are usually moved from the operating theater to the High Dependency Unit (HDU) for some monitoring right after the surgery itself. Patients are transferred here as they require close monitoring similar to individuals with extremely high blood pressure. In the High Dependency Unit, the patients breathing, blood pressure and heart rate will be closely monitored for any irregularities. Individuals can usually eat and drink within a few hours after surgery and can usually leave the hospital in about forty eight (48) hours after the Carotid Ischemic Surgery.
After being discharged from the hospital, the doctor will give some recommendations to the patients in terms of wound care, specifically for the surgical wound around the patient’s neck. Wound care will usually be composed of keeping the wound clean and infection free by washing it with mild soap and water. The stitches used for the wound will usually be a dissolvable stitch or skin glue that will eventually dissolve on its own. Patients usually have a scar after the Carotid Ischemic Surgery.