Journal of Vascular and Endovascular Therapy

Description

Carotid endarterectomy is a surgical procedure performed to reduce the risk of stroke in individuals with carotid artery stenosis. This condition occurs when the carotid arteries which supply oxygen rich blood to the brain become narrowed or blocked due to the plaque. Stroke one of the leading causes of death and disability worldwide can often be prevented through timely intervention. This procedure is widely recognized for its efficacy in treating carotid artery disease particularly in symptomatic patients or those with severe asymptomatic stenosis. Carotid artery disease arises from atherosclerosis a process where fatty deposits cholesterol and other substances accumulate on the arterial walls forming plaques. These plaques can narrow the arteries or rupture potentially causing blood clots that travel to the brain leading to ischemic stroke. Transient ischemic attacks often called mini strokes characterized by temporary vision changes speech difficulties or weakness on one side of the body. Dizziness confusion or fainting in some cases. Smoking high blood pressure diabetes and high cholesterol. A family history of atherosclerosis or vascular diseases is often performed to complement medical therapy including antiplatelet drugs cholesterol lowering medications and lifestyle changes. For many patients the procedure offers a superior alternative to medical management alone particularly in reducing the long term risk of major strokes.

Anesthesia

Carotid endarterectomy is performed under local or general anesthesia depending on patient and surgical considerations. A small incision is made on the side of the neck to access the affected carotid artery. The artery is clamped to stop blood flow temporarily. A shunt may be placed to maintain blood supply to the brain. The surgeon opens the artery and carefully removes the plaque. The inner lining of the artery is smoothed to restore normal blood flow. The artery is closed using sutures sometimes with a patch to reinforce the repair and reduce the risk of restenosis. The incision is closed and the patient is moved to recovery for monitoring. The procedure generally takes and patients are often discharged within hours depending on their condition. The procedure significantly reduces the risk of recurrent stroke especially in symptomatic patients with severe stenosis. Durability provides long-term protection against future strokes with a low recurrence rate of stenosis by preventing disabling strokes patients maintain better functional independence and overall wellbeing. Studies such as the north symptomatic careful patient selection, preoperative assessment and surgical expertise minimize these risks. Carotid artery stenting is a less invasive alternative to where a stent is placed in the artery to keep it open.

Neurological

While both procedures are effective in reducing stroke risk there are key difference may be slightly more effective in preventing perioperative stroke particularly in older patients. Risk carries a higher risk of embolic stroke during the procedure while has a higher risk of myocardial infarction. Patient selection is often reserved for patients who are at high surgical risk due to anatomy or comorbidities. The choice between and depends on individual patient factors and multidisciplinary evaluation. After the procedure patients are monitored for signs of complications including neurological changes or bleeding. Recovery typically involves hospital stay most patients are discharged within one to two days. Medications continued use of antiplatelet agents and statins to prevent restenosis. Lifestyle modifications Smoking cessation a heart healthy diet and regular exercise are essential to maintaining vascular health. Patients generally resume normal activities within two to four weeks depending on their overall health and recovery progress. Significant reduction in the risk of major stroke in both symptomatic and selected asymptomatic patients. A low recurrence rate of stenosis with most patients requiring additional interventions. Combined with medical therapy and lifestyle changes offers a durable solution for managing carotid artery disease and preventing stroke. Carotid endarterectomy is a proven and effective surgical intervention for reducing the risk of stroke in patients with significant carotid artery stenosis. By directly addressing the underlying cause of ischemic stroke improves long term outcomes and enhances patient’s quality of life. Despite its risks careful patient selection and advances in surgical techniques have made a cornerstone in the management of carotid artery disease. For individuals at high risk of stroke this procedure offers a saving opportunity to regain vascular health and maintain neurological function.