A B C D E F G H I J K L M N O P R S T U V W

CAROTID ARTERY SURGERY

What is Carotid Artery Surgery ?

When a transient ischaemic attack (TIA) or a stroke occurs, attempts are made to find the underlying cause and to prevent further attacks. Sometimes, it is found that the main artery to the affected side of the brain is narrowed by thickening of the its wall (atheroma). Doctors may then consider surgery to remove the damaged surface of the vessel so that a good flow of blood is restored and a source of blood clots (emboli) is removed. They hope that this will reduce the chance of future strokes. Research has shown that if the artery on the affected side is narrowed by more than about 70%, the benefits of surgery are likely to outweigh the risks. If the artery is completely blocked, or less severely narrowed, medical treatment is usually preferred.

Preparations needed for Carotid Artery Surgery

You will usually stay in hospital for less than one week. Special scans and ultrasound tests are usually carried out as an outpatient before the operation. You will need to count on a few weeks to recover.

What Happens during Carotid Artery Surgery

The operation is usually performed under general anaesthesia. An incision is made along the side of the neck, where the main carotid artery divides into the portion that supplies the brain and that which supplies the face. This is the point that narrowing and clots usually develop. The carotid artery is identified and its circulation stopped so that it can be opened. Mostly, the narrowed area will be bypassed during surgery to allow blood to get to the brain. It is then possible to remove the diseased layer of the blood vessel, thus clearing it out and making it wider. The artery is then closed again and the circulation restored.

Possible Complications during Carotid Artery Surgery

The major complication with carotid artery surgery is the development of stroke either during or immediately after the operation. A stroke of some kind occurs in about 3-5% of patients who have this operation This may be due to poor circulation to the brain during the operation on the carotid artery or to clot being dislodged and travelling upwards to the brain. The surgeon should be able to tell you what the likely risk of a stroke due to the operation will be. The likelihood of stroke resulting from carotid artery surgery must be considered to be low before the surgeon can justify the operation. Where the operation is performed, it is considered by the surgeon and neurologist that the risks of not operating are greater than the risks of doing it. You should discuss any concerns carefully with your surgeon. Apart from the possible complication of a stroke, the operation is reasonably trouble free. Some people develop temporary hoarseness or difficulty swallowing. There is a risk of a chest infection or a headache. Recovery is generally quick and complete.

After Carotid Artery Surgery

Return to work should be possible in a matter of weeks. There is some restriction of driving. Repeat visits are necessary, at which ultrasound checks of your carotid artery may be performed. You are likely to be placed on regular aspirin or an alternative drug to further reduce the risk of clot formation.

If Carotid Artery Surgery is not performed

In patients with a very narrow carotid artery, there is a significant risk of a major stroke. This could be as high as one in five people having a stroke in the next few years. The risk can be reduced by taking aspirin, but in suitable patients, successful carotid artery surgery can almost completely remove the risk of stroke in the same period of time.