Carotid Endarterectomy for Stroke Prevention

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What is Carotid Endarterectomy?

Carotid Endarterectomy (CEA) is a surgical procedure designed to reduce the risk of stroke by removing plaque buildup from the carotid arteries, which are the major blood vessels in your neck that supply blood to the brain. The buildup of plaque in these arteries can reduce blood flow to the brain, increasing the risk of stroke.

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Why is Carotid Endarterectomy Recommended?

Carotid Endarterectomy is typically recommended when there is a significant blockage in one or both of the carotid arteries in the setting of a mini stroke (TIA) or stroke. This procedure can help prevent strokes by improving blood flow to the brain and reducing the risk of a piece of plaque breaking off and causing a blockage in a smaller blood vessel in the brain.

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Benefits of Carotid Endarterectomy:

1. Stroke Prevention: The primary benefit of CEA is reducing the risk of stroke in patients with carotid artery stenosis (narrowing) caused by plaque buildup.

2. Improved Blood Flow: CEA restores normal blood flow to the brain, which can help prevent further brain damage.

3. Symptom Relief: In some cases, CEA can alleviate symptoms such as dizziness, vision problems, and weakness in the face or limbs caused by reduced blood flow to the brain.

 

Risks and Complications:

While Carotid Endarterectomy is generally considered safe, like any surgical procedure, it carries some risks and potential complications. These include:

1. Stroke: There is a small risk of stroke during or after the procedure.

2. Heart Attack: In rare cases, patients may experience a heart attack.

3. Bleeding: There may be bleeding at the surgical site.

4. Infection: Infections at the incision site are possible but uncommon.

5. Nerve Damage: There is a slight risk of damage to nerves in the neck, which can cause temporary or permanent hoarseness.

6. Blood Clots: Blood clots in the legs (deep vein thrombosis) or lungs (pulmonary embolism) are rare but possible complications.

A competent and qualified surgeon will have a very low rate of complications, usually less than 1%.

 

Alternatives to Carotid Endarterectomy:

In some cases, your healthcare provider may recommend alternative treatments or approaches to manage carotid artery blockage and reduce stroke risk.

These alternatives include:

1. Carotid Artery Stenting: This is a minimally invasive procedure where a stent (a small mesh tube) is placed in the narrowed artery to keep it open. In most cases, however, the risk of stroke during the procedure is slightly higher than for carotid endarterectomy, and thus is not recommended as first line.

2. Medication: Lifestyle changes and medications to control risk factors such as high blood pressure, high cholesterol, and diabetes may be recommended to reduce plaque buildup and lower the risk of stroke.

3. Observation: In some cases, if the blockage is not severe and the risk of surgery is high, your doctor may recommend closely monitoring your condition without immediate surgery.

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Conclusion:

Carotid Endarterectomy is a surgical procedure aimed at reducing the risk of stroke by removing plaque buildup in the carotid arteries. While it has benefits in stroke prevention, it also carries certain low but significant risks. It is essential to discuss your individual situation with your healthcare providers to determine whether CEA or an alternative approach is the most suitable option for you.

 

Dr Simon Vun, FRACS will consider your overall health, the severity of the blockage, and other factors to make the best treatment recommendation.

 

Please feel free to ask any questions or voice any concerns you may have about this procedure with your healthcare team.