Carotid artery surgery is necessary to regain normal blood flow when the artery becomes blocked with fatty plaque. The carotid arteries run along each side of your neck and bring blood to your brain, so when they are 60% or more clogged with plaque, it can lead to a stroke. A doctor’s first choice for carotid artery surgery is usually an endarterectomy, in which he makes a cut along your neck and artery to remove the plaque buildup. This type of surgery has several risks involved and might not be recommended if you have had a previous stroke. If an endarterectomy is deemed unsafe, a doctor might perform an angioplasty and place stents in your artery instead.
Prior to having carotid artery surgery, your doctor might give you preoperative instructions. Your doctor might advise you to stop taking certain medications that can interfere with the procedure. Also, you will typically be told not to drink anything after midnight before your surgery. In addition, you should let your doctor know about any illnesses or flu symptoms you are experiencing before the surgery.
On the day of your carotid artery surgery, you will be given anesthesia. In many cases, you will undergo general anesthesia so you will be unconscious and feel no pain. Some doctors prefer local anesthesia, however, which will only numb the area being operated on. The risks involved with anesthesia include breathing problems and allergic reactions, so you might be asked to sign a waiver before receiving it.
If you are having an endarterectomy carotid artery surgery, you will be on your back on the operating table with the blocked artery side of your neck facing up. Your surgeon will then make a cut along your neck just above the blockage in the carotid artery. Usually, a shunting procedure will be done, in which he puts a small plastic tube, called a catheter, in place above and below the blockage to allow blood to go through to the brain. In some cases, the surgeon might just temporarily stop the blood flow instead of using the catheter. Next, he will open the artery, remove the plaque buildup, and stitch the artery closed again.
The risks involved with having carotid artery surgery include heart attack, blood clots, bleeding in the brain, and brain damage. In rare cases, you could have a stroke or seizures. After the surgery is done, you might need to stay overnight in the hospital to be monitored for such complications. Also, your doctor might recommend lifestyle changes to prevent plaque from building up in your arteries again.
The second option for carotid artery surgery is an angioplasty with stent placement. This procedure usually only requires local anesthesia, and your surgeon will make a cut in your groin area. A tube will be inserted into the cut and directed through the arteries to the blockage in your carotid artery using live x-ray technology.
Next, a guide wire is inserted into the catheter, followed by another wire with a tiny balloon on the end. Once the balloon is in the carotid artery, it is blown up so that it pushes against the sides of your artery. This opens it up enough to restore proper blood flow. At the same time the balloon is being put in place, your surgeon will also insert a stent, which is a tube of wire mesh, into the blocked area. The stent expands when the balloon does, but it is left in place while the balloon is removed.