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By restoring adequate blood flow to the internal carotid artery, strokes can be prevented. This may be accomplished either by a surgery called endarterectomy or a procedure known as angioplasty with stent placement. Traditionally used for the heart, this latter procedure is now being used on blood vessels to the brain as well. Stent placement is an alternative to surgery that enlarges the blockage in the artery. This new technique must only be performed by an experienced physician.
During the procedure, there are steps the surgeon takes to reduce the risk of stroke from the operation. These include shunting (using a plastic tube to re-route blood flow to the brain), EEG monitoring, or even doing the operation under local anesthetic so the patient can talk to the surgeon. Usually, however, general anesthesia is used, which allows the patient to be unconscious and pain free.
Surgery should also be done for those who have carotid artery blockages which cut off between 75-99% of blood flow through this major artery. Large studies have shown that for people with such severe blockages, even if they have no symptoms at all, the risk of stroke is reduced with surgery.
If the blockage is complete (100%), however, surgery will not be performed because the risk of stroke and significant brain damage from the procedure is too great.
X-ray studies using special dyes (carotid angiogram) can show the degree of blockage of the carotid arteries. Other studies that can visualize blockages in the carotid arteries are ultrasound and magnetic resonance angiography (MRA).
Additional risks of carotid surgery include Blood clots, damage to the Brain, Strokes or even Heart attacks.
Carotid artery surgery usually helps prevent further brain damage and reduces the risk of stroke. However, unless lifestyle changes (like diet and exercise when approved by your physician) are made, plaque buildup, clot formation, and other problems in the carotid arteries can return.
After surgery, you are usually observed overnight to watch for any signs of bleeding, stroke, or compromised blood flow to the brain. However, there is a recent trend to send the patient home the same day, if the operation is done early and the patient is doing well. |