What is Carotid endarterectomy?

Why does one need a carotid endarterectomy?  

Transient ischemic attack or TIA is the first sign of carotid artery disease. The blocks keep building up and block the flow of blood to cause symptoms. If an artery is only partially blocked, then it does not show any signs.   

The procedure followed for carotid endarterectomy depends on the patients' health condition. Other procedures that can be done are carotid angioplasty and stenting.   

First, the patient has to empty the bladder before the surgery begins. An IV line is inserted into the arm, and a catheter is then inserted into the wrist to monitor the blood pressure. The patient's heart rate is monitored using catheters inserted opposite to the region of surgery. The head is kept in a raised position, and the face is positioned away from the surgical area while lying on the back. The urine is drained during the procedure using a catheter.    

A carotid endarterectomy can be carried out using local anaesthesia or general anaesthesia.    

Under local anaesthesia, the patient may feel sleepy and not feel any pain in the operated area. But in the case of general anaesthesia, the patient will fall asleep. A breathing tube will be connected to the throat into the windpipe so that the lungs get sufficient air. A ventilator will also be provided to help the patient breathe. Antibiotics are given through IV to prevent any infection from developing during the procedure,   

An incision is made on the side of the neck, and the artery is then cut when exposed. A device called a shunt is used to keep the blood flow to the brain constant. The shunt diverts the blood flow around the surgery area. It's a tiny tube put into the carotid artery to circulate blood around the surgical site. The plaque is removed from the artery, as well as the shunt. The artery is closed by stitching the incision made on the neck. Next, a drain or small tube is placed in the neck to drain the blood into a palm-size suction bulb. Blood pressure medicines are given to the patient through the IV during and after the procedure to maintain the pressure level.   

What can you expect during post-surgical care for carotid endarterectomy?  

The patient will be moved to the recovery room post-surgery, and it usually takes 1 or 2 days to get back home after carotid endarterectomy. Blood pressure, pulse and breathing ability will be monitored at the hospital. The drainage tube will be removed by the healthcare provider the following day. Painkillers are also usually prescribed by doctors to ease any pain or discomfort post-surgery.   

At home, the incision area requires greater care. Bathing and cleaning instructions provided by the doctor have to be taken on a serious note. If any adhesive strips are used, they will fall off within few days. Patients are also advised to eat vegetables, fruits, non-fat dairy products and avoid highly processed foods during recovery.