Carotid endarterectomy





Definition

Carotid endarterectomy (CEA) is a surgical procedure that is performed to remove deposits of fat, called plaque, from the carotid arteries in the neck. These two main arteries, one on each side of the neck, deliver blood and oxygen to the brain. Plaque builds up in large- and medium-sized arteries as people get older, more in some people than others depending on lifestyle and hereditary factors. This build up is a vascular disease called atherosclerosis, or hardening of the arteries. When this happens in either one or both of the carotid arteries, they can become narrowed, a condition called stenosis. During a carotid endarterectomy, a surgeon removes the fatty deposits to correct the narrowing and to allow blood and oxygen to flow freely to the brain.


Purpose

Carotid endarterectomy is a protective procedure intended to reduce the risk of stroke, a vascular condition also known as a cardiovascular accident (CVA). In studies conducted by the National Institute of Neurological Disorders and Stroke (NINDS), endarterectomy has proven to be especially protective for people who have already had a stroke, and for people who are at high risk for stroke or who have already been diagnosed with significant stenosis (between 50% and 70% blockage).


Demographics

The National Stroke Association reports that twothirds of stroke victims are over age 65. Risk is shown to double with each 10 years over age 55. Men are more at risk than women, although most stroke survivors over age 65 are women, which may be partly because there are more women than men in this age group. African Americans have been shown to be at greater risk for stroke than other racial groups in the United States. Risk is also higher in people who have a family history of stroke as well as people with diabetes, because of the circulatory problems associated with diabetes. People with high blood pressure, also called hypertension, have four to six times the risk of stroke.

Nearly 700,000 strokes occur in the United States each year, with about 150,000 deaths, making stroke the third leading cause of death behind heart disease and cancer. Stroke is also responsible for the high number of disabled adults in the United States; two million stroke survivors have some permanent disability. The annual cost to the country for treating stroke and disabilities caused by stroke is about $40 billion.

In a carotid endarterectomy, the carotid artery is access through an incision in the neck (A). A measurement of the pressure inside the vessel is taken to assess the degree of blockage (B). The carotid is clamped above and below the incision, and a shunt is inserted to maintain blood flow (C). Plaque lining the artery is removed (D). The shunt is taken out (E), and the incisions are repaired (F). (Illustration by GGS Inc.)
In a carotid endarterectomy, the carotid artery is access through an incision in the neck (A). A measurement of the pressure inside the vessel is taken to assess the degree of blockage (B). The carotid is clamped above and below the incision, and a shunt is inserted to maintain blood flow (C). Plaque lining the artery is removed (D). The shunt is taken out (E), and the incisions are repaired (F). (
Illustration by GGS Inc.
)

Description

The presence of fatty deposits in the carotid arteries of the neck is the most significant risk factor for ischemic stroke, which represents 80% of all strokes. A stroke can be either ischemic, which is an interruption of blood flow in a narrowed carotid artery, or hemorrhagic, which involves bleeding in the brain. Carotid endarterectomy is performed as prevention of ischemic strokes.

Some people at high risk for ischemic stroke have disturbing symptoms that can occur periodically and last from minutes to up to 24 hours, and then disappear. These episodes are called transient ischemic attacks (TIA). The symptoms are the same as actual stroke symptoms. The symptoms of TIA and ischemic stroke may include:

  • Numbness, muscle weakness, or paralysis of the face, arm, or leg, usually on one side of the body, and usually occurring suddenly.
  • speech or vision difficulties
  • sudden loss of understanding, confusion
  • lightheadedness or fainting spells
  • loss of balance with difficulty walking and moving; poor coordination
  • severe headache with no obvious cause, either sudden or persistent

About 35% of people who have TIAs will have a stroke within five years. The risk of stroke goes up with age and is greatest in people whose blood pressure is higher than normal. High blood pressure stresses the walls of blood vessels, particularly when the vessels are blocked with plaque and so space for blood to pass is reduced.

Carotid endarterectomy has been performed since the 1950s as a stroke-prevention method. During the 1990s, about 130,000 carotid endarterectomies were performed each year in the United States. Because the surgery itself presents a high risk of complications, surgeons will look at the possible benefits and risks for each patient and compare them with such medical treatment as drug therapy to reduce plaque, cholesterol, and blood pressure. Carotid endarterectomy is typically performed on those who will benefit most from the surgery and who have the lowest risk for postoperative complications. Good candidates include:

  • People who have already had one or more TIA episodes in a six-month period, with 70% narrowing of the carotid arteries supplying the part of the brain affected by the TIA.
  • People who have had a mild stroke in the past six months but who are not significantly disabled and whose carotid arteries are at least 70% narrowed.
  • People who have not had a stroke or TIA, but their carotid arteries are narrowed 60% or more and they have low risk of complication from having the surgery.

Carotid endarterectomy is not recommended for:

  • People whose risk of complications from the surgery is greater than the intended benefits. The presence of other problems such as heart disease may increase risk.
  • People who have had a TIA but their carotid arteries are less than 50% narrowed.
  • People who have had a stroke or TIA because arteries other than the carotid arteries are blocked.
  • People whose carotid arteries are blocked above a point on the neck where they can be reached easily during surgery.

The endarterectomy procedure takes about an hour to perform. General anesthesia is usually administered. A vascular surgeon or neurosurgeon will usually perform the surgery. During the procedure, a small incision is made in the neck below the jaw to expose the carotid artery. Blood that normally flows through the artery must be diverted in order to perform the surgery. This is accomplished by rerouting the blood through a tube (shunt) connecting the vessels below and above the surgical site. The carotid artery is opened and the waxy fat deposit is removed, sometimes in one piece. If the carotid artery is observed to be too narrow or too damaged to perform the critical job of delivering blood to the brain, a graft using a vein from the patient's leg may be created and stitched (grafted) onto the artery to enlarge or repair it. The shunt is then removed, and incisions in the blood vessels, the carotid artery, and the skin are closed.


Diagnosis/Preparation

Diagnosis

The presence and degree of stenosis in the carotid artery must be determined before a doctor decides that carotid endarterectomy is necessary. Carotid stenosis can sometimes be detected in a routine checkup, especially when a detailed history reveals to the doctor that the patient has experienced symptoms of TIA or stroke. The doctor will use a stethoscope to listen to blood flow in the carotid artery and may hear an abnormal rushing sound called a "bruit" (pronounced "brew-ee") that will indicate narrowing in the artery. The absence of sound, however, does not mean there is no risk. More extensive testing will most likely have to be done to determine the degree of stenosis and the potential of risk for the patient. These tests may include:

  • Ultrasound imaging with Doppler—a painless, noninvasive imaging test that measures sound waves directed into the body and returned to the ultrasound machine as echoes. Usually these echoes are visualized as an image on a screen; Doppler captures the sound as the echoes bounce off of moving blood in the carotid artery, giving some indication of the amount of blockage as the ultrasound probe moves up and down the arteries on each side of the neck.
  • Computed tomography (CT) or computer-assisted tomography (CAT scan)—a series of cross-sectional x rays of the head and brain that can rule out other causes for the symptoms but cannot detect carotid artery stenosis.
  • Oculoplethysmography (OPG)—a procedure that measures the pulsing of arteries behind the eye, which can show carotid artery blockage.
  • Arteriography and digital subtraction angiography (DSA)—special x-ray procedures using dye in the patient's vascular system. These tests are invasive and can actually cause a stroke, but they do indicate more exactly what degree of stenosis is present. The doctor will have to weigh the extent of risk and how much the patient will benefit from the tests.
  • Magnetic resonance angiography (MRA)—an imaging test that does not use dyes or x rays and relies on special computer software and powerful magnetic fields to create a highly detailed image of the inside of the brain's arteries.

Preparation

If carotid ultrasonography or arteriography procedures were not performed earlier to diagnose carotid stenosis, these tests will be performed before surgery to evaluate the amount of plaque and the extent and location of narrowing in the patient's carotid arteries. Other blood vessels in the body are also evaluated. If other arteries show significant signs of artherosclerosis or damage, the patient's risk for surgery may be too great, and the procedure will not be performed. Aspirin therapy or other clot-prevention medication may be prescribed before surgery. Any underlying medical condition such as high blood pressure or heart disease will be treated prior to carotid endarterectomy to help achieve the best result from the surgery. Upon admission to the hospital , routine blood and urine tests will be performed.

Aftercare

A person who has had carotid endarterectomy will be monitored in a hospital recovery room immediately after the surgery and will then go to an intensive care unit at least overnight to be observed for any sign of complications. The total hospital stay may be two to three days. When the patient returns home, activities can be resumed gradually, as long as they are not strenuous. During recuperation, the patient's neck may ache slightly. The doctor may recommend against turning the head often or too quickly during recovery. The most important thing people can do after endarterectomy is to follow their doctor's guidelines for stroke prevention, which will reduce the progression of artherosclerosis and avoid repeat narrowing of the carotid artery. Repeat stenosis (restenosis) has been shown to occur frequently in people who do not make the necessary changes in lifestyle such as in diet, exercise , and quitting smoking or excessive use of alcohol. The benefits of the surgery may only be temporary if underlying disease such as artherosclerosis high blood pressure, or diabetes, is not also treated.


Risks

Serious risks are associated with carotid endarterectomy. They involve complications that can arise during or following the surgery, as well as underlying conditions that led to blockage of the patient's arteries in the first place. Stroke is the most serious postoperative risk. If it occurs within 12 to 24 hours after surgery, the cause is usually an embolism, which is a clot or tissue from the endarterectomy site. Other major complications that can occur are:

  • heart attack or other heart problems
  • death
  • breathing difficulties
  • high blood pressure
  • nerve injury, which can cause problems with vocal cords, saliva management, and tongue movement
  • bleeding within the brain
  • restenosis, the continuing buildup of plaque, which can occur from five months to 13 years after surgery

The risks of carotid endarterectomy surgery depend upon age, overall health, and the skill and experience levels of the surgeons treating the patient. The likelihood of complications is lower when the surgeon performing the procedure has acknowledged skills and experience. According to the Stroke Council of the American Heart Association, surgery is best performed by a surgeon who has only had complications occur in less than 3% of patients. Hospitals, too, should be able to show that fewer than 3% of their patients undergoing endarterectomy have had complications. These recommendations are based not only on skill levels, but also on the ability to accurately weigh the stroke risks for each patient against the potential risk of complication because of age, hereditary factors, and the presence of underlying conditions or diseases.


Normal results

The desired outcome of carotid endarterectomy is improved blood flow to the brain and a reduced risk of stroke. The National Stroke Association has reported that successful carotid endarterectomy surgery reduces risk of stroke by as much as 80% in people who have had either transient ischemic attacks or symptoms of stroke, or who have been diagnosed with 70% or more arterial blockage. Studies of people who have no symptoms but have been found to have stenosis from 60% to 99%, show that endarterectomy surgery also reduces the risk of stroke by more than 50%. These groups of people at higher risk for stroke will benefit most from having carotid endarterectomy. The benefit for people who have lesser degrees of blockage is shown to be much lower than that of high-risk stroke candidates. Surgery is not indicated for people with artery narrowing less than 50%.

Morbidity and mortality rates

Death and disabling stroke occur more often in symptomatic and asymptomatic patients at high risk for stroke who have not been treated with carotid endarterectomy surgery. A well-respected study, the North American Symptomatic Carotid Endarterectomy Trial (NASCET), along with a corresponding European study (ECST), showed that death or disabling stroke are reduced by 48% among those with severe stenosis (greater than 70%) when they undergo carotid endarterectomy surgery. In patients with less severe stenosis (50–69%), endarterectomy was shown to reduce risk by 27%. Patients with less than 50% stenosis were actually harmed by surgery, increasing the risk of death or disability by 20%. The conclusion of the study was that death and disability could be reduced overall if carotid endarterectomy was performed only on patients with the more severe stenosis who are also surgically fit, and that that the procedure should be performed only by surgeons whose complication rates are less than 6%.


Alternatives

The carotid endarterectomy removes plaque directly from blocked arteries and there is no alternative way to mechanically remove plaque. However, there are alternative ways to prevent the buildup of plaque and thus help to prevent stroke or heart attack. Certain vitamin deficiencies in older people are known to promote high levels of homocysteine, an amino acid that contributes to atherosclerosis, putting people at greater risk for stroke or heart attack. Certain nutritional supplements have been shown to reduce homocysteine levels.

Nutritional supplements and alternative therapies that are sometimes recommended to help reduce risks and promote good vascular health include:

  • Folic acid, which helps lower homocysteine levels and increases the oxygen-carrying capacity of red blood cells.
  • Vitamins B 6 and B 12 , which help lower homocycteine levels; B6 is also a mild diuretic and helps to balance fluids in the body.
  • Antioxidant vitamins C and E, which work together to promote healthy blood vessels and improve circulation.
  • Angelica, an herb that contains coumadin, a recognized anticoagulant, which may help to prevent clot formation in the blood (blood thinner).
  • Essential fatty acids, which help reduce blood pressure and cholesterol, and maintain elasticity of blood vessels.
  • Chelation therapy, which can be used to break up plaque and improve circulation.

Resources

BOOKS

Caplan, L. R. American Heart Association Family Guide to Stroke Treatment, Recovery, and Prevention. New York: Times Books, 1994.

Moore, R. D. The High Blood Pressure Solution: A Scientifically Proven Program for Preventing Strokes and Heart Disease, 2nd Edition. Portland, OR: Inner Traditions, 2001.


PERIODICALS

Harrar, S. "Brain Attack." Prevention Magazine 20 September 2002.


ORGANIZATIONS

National Institute of Neurological Disorders and Stroke (NINDS). National Institutes of Health, Bethesda, MD 20892. http://www.ninds.nih.gov .

National Stroke Association. 9707 E. Easter Lane, Englewood, CO 80112. (800) Strokes or (303) 649-9299. http://www.stroke.org .


OTHER

Carotid Endarterectomy: Questions and Answers. Harvard Medical School and Aetna. http://www.intelihealth.com .

Carotid Endarterectomy: What to Think About. Healthwise, Inc., Boise, ID. http://www.laurushealth.com/newsearch .

Uncontrollable Stroke Risk Factors and Controllable Stroke Risk Factors. National Stroke Association, Stroke Prevention Guidelines. http://www.stroke.org .


L. Lee Culvert

WHO PERFORMS THE PROCEDURE AND WHERE IS IT PERFORMED?


Carotid endarterectomy is performed in a hospital or medical center operating room by a vascular surgeon or neurosurgeon.

QUESTIONS TO ASK THE DOCTOR


  • Why do I need this surgery?
  • How will the surgery improve my condition?
  • What kind of anesthesia will I be given?
  • What are the risks of having this surgery?
  • Is there anything I can do, myself, to get in shape for the surgery and to improve my chances of successful surgery?
  • How many of these procedures have you performed? How many of the surgery patients had complications after surgery?
  • How can I expect to feel after surgery? How long will it take me to recover?
  • What are my chances of developing this problem again after the surgery?
  • If the surgery is not successful, what will my options be?


User Contributions:

Yoshihiko Nomi
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May 3, 2006 @ 8:08 am
It is mentioned that ultrasound imaging with Doppler is used for diagnosis; do you use any surgery type probes during the procedure for monitoring purpose or aftercare.

Thank you,

Best regards,

Y. Nomi
Barbara Clark
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Mar 13, 2008 @ 10:10 am
Good article on surgery and selecting surgeon/hospital
CW
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Mar 18, 2008 @ 6:18 pm
I felt this article was extremely helpful to me and my family. Thank you so much.
cecilia
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Apr 2, 2008 @ 10:10 am
I'm a first semester Nursing Student and we have to do all the patho behind our patient's diagnoses. This article gave me all I was looking for!!! Thank you so much!!! The article was flowing great in details and explanations! This is so helpful!!
V.Allen
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Sep 29, 2008 @ 3:15 pm
My father is 74. He had a carotid Endarterectomy about three weeks ago. Six days after the surgery he started to experience total weakness and use of his legs. As a result, he was hospitalized for a week for test -- Nothing could be found to cause this trouble. He must now get around in a wheel chair. I would appreciate any advice or possible cause. He had the surgery at Pitt Memorial Hospital in NC. He is scheduled for another follow up on 1 Oct 08.

Sincerely,
V. Allen
John G
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Jun 8, 2009 @ 2:14 pm
What about carotid stents? I have heard that in the hands of skilled interventionalist these are a reasonable alternative to patients with higher surgical risk?
anita
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Aug 3, 2009 @ 4:04 am
My father is 57. He had a carotid Endarterectomy about 1 month ago. he also got 2 stroke after fourth day of surgery doctor hospitalized him for fifteen days more now he is ok now but he started to experience total weakness and use of his body parts his BP is still fluctuating upto 180 although walking and doing daily work. I dont know the cause, I would appreciate any advice or possible cause.
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Apr 1, 2010 @ 2:14 pm
Excellent format and through coverage to ease a patient and loved ones' anxiety.
Thank you.
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Jun 27, 2010 @ 8:08 am
My husband is 62 and had a carotid Endarterectomy his voice is funny not able to clear his throat and when could he start driving and working again
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Jul 8, 2010 @ 10:22 pm
Good info I am going to send this to my mom who is having this surgery soon and this has been very informational
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Sep 3, 2010 @ 8:08 am
Hey T.G.I.F,
I guess this is the best info I can get {and give} on the surgery.
Andrea
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Oct 2, 2010 @ 10:10 am
My sister is going to have the carotid endarterectomy surgery one day next week,So she wanted me to look it up and tell her what it is really and how it is done,cause when doctors come in and start talking you really dont know what they are saying , So thanks the informations it was very helpful
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Oct 17, 2010 @ 11:11 am
Hello, My name is Wayne my father age 70 just past Tuesday (10-13-10) had a carotid arterie operation on the left side of neck. It was 75% blockage and the other was 95% blockage. The 75% the doctor said it needed to be work on before the 95% because it was block in more than one spot. He went through the operation great but he can not get the blood pressure to keep normal. He is a heavy smoker and a take shot diabete. The surgerant past he to his reg doctor and dad is not doing good. His blood pressure spikes up to 225 at time and hard to get it down taking some kind of pills to bring it down but sometimes it take about 20 minutes to start comming down. He has been going late at night to the hospital to get it down. He is still fighting the high blood pressure... My question is HOW LONG WILL HE HAVE TO FIGHT THIS HIGH BLOOD PRESSURE. The doctor said that the brain has to read the flow and pressure before a normal pressure. The heart been use to work harder to push the blood. He feels fine but blood pressure is not working for him.. Thanks Wayne
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Oct 26, 2010 @ 11:23 pm
I am a candidate for this procedure. I have one additional problem. The Doppler and CAT scans indicate 100% blockage in the left carotid artery and 60 % in the right. It is the right one that will be addressed. I had some vision problems in my right eye and this led my doctors to this point. We have known about the left total occlusion for several years. I had a triple by-pass operation in 1984 without any problems. Scans of that operation showed blockage but indicated re-channeling of the blood.
I am 78 yoa and in relatively good health. I think that the above history places me at a greater risk than usual. Do you have any suggestions? I'm ready to go do it.
Thank you.
Sam Litzenberg
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Nov 21, 2010 @ 3:15 pm
am i at greater risk for complications during surgery on my right artery(85% blocked) since my left artery is completely closed. which procedure
would be less risky?
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Dec 28, 2010 @ 11:11 am
Need help please. We live in Peu and muy husband of 65 has been diagnosed with carotid obstruction the left 85% and the right one 95%. We visited several doctors who recomend surgery and we are very scared about the risks
My question is exists any therapy to reduce the problem not necesarily surgery?
One day in this december 2010 he felt dizzy and his left hand dormed so we went to emergency
and after exams we knew about the corotids.
He has no colesterol and his blood presure in controled with medicine and he has no other problems. Please any specialized doctor who reads this , let me know what to do.
I´ll be waiting and thanks a lot.
Niky
Kathy
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Jan 11, 2011 @ 11:23 pm
We recently learned that my husband (age 71) has 99% blockage on left carotid. He had open heart surgery for valve replacement and double by pass 3 1/2 years ago. He will have the carotid Endarterectomy surgery in the next couple of weeks. We apprecite all the information in this article. It 100% backs up what the surgeon told us last week. Of course, our goal is to prolong a healthy life and reduce as much as possible his stroke risk. There were no indications of problems--just a routine physical exam due to a switch in our primary care physician. We feel fortunate and are optomistic. The comments of post surgery issues have me a bit concerned... I thought we'd be okay after the first 24 hours. I'll be watchful.
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Jan 14, 2011 @ 9:09 am
After seeing you New Years we knew this was a possibility. Same as what my Dad had and they went well. Wayne, you are a tough and your attitude for life is your best armour. You know that our thoughts and prayers will be with you. As you say, just a little bump in the road.

You have to get well soon being as we are going to Mexico in the Spring. And YES, I have my passport stuff all ready to submit.

Love you guys

Mary Kaye and Nick
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Jan 16, 2011 @ 10:10 am
my husband just had this surgery 6 days ago. his blood pressure has been a little high, but today it dropped significantly. when should i become concerned enough to take him to the er?
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Jan 22, 2011 @ 3:15 pm
Was preparing for both knee replacements, and they found an 80% stenosis on the right side. Had surgery Tues, Jan 18th, came home next day. Dr. said I was doing great. I was ready for my own bed. I do have a little swelling which Dr. told me I would have. I have a great heart doctor, who recommended the Vascular Dr. in Wichita. I would recommend both to any one that needs great doctors. Now, surgery for knees is scheduled for Feb. 7th. I'm ready to get on with my life. Thanks for the informative document on Endarterectomy.
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Feb 2, 2011 @ 2:14 pm
hi nice informative article to know about Carotid endarterectomy (CEA) surgical procedure
vicki vanbrunt
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Feb 5, 2011 @ 3:15 pm
My husband had the operation Jan 19th. Left side of neck, he is having a problem everytime he eats & chews. He has pain in the jaw & side of neck, I made him eggs & toast and the bread was hard for him even chichen cut up small. I don't remember this problem 6 years ago when he had the surgery on right side. We told the doctor & he said eat slow & it might take awhile yet. This time they had to put in a pigs artery I believe. He had no problems last time, but I was wondering if this is normal to hurt even if it is soft bread.
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Mar 17, 2011 @ 7:19 pm
just had the surgery two days ago, feeling pretty good.very tired,and some soreness okon surgery side{right side}ok so far
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Mar 31, 2011 @ 7:19 pm
I am a 2nd year Operating Department Practice (ODP) student. This article has useful information and has helped me in my case study.Thank you.
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Apr 14, 2011 @ 10:10 am
I had carotid artery surgery 3 years ago on the left artery. Sometimes I get pain over the incision site. Is this a problem.

Carmen
Debbie
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Aug 28, 2011 @ 12:12 pm
Very informative article, it answered the questions and more that I was searching for. Thank You
Fred Jachem
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Oct 18, 2011 @ 5:17 pm
11-18-2011;
Just had a carotid endarterectomy (CEA) surgical procedure done on my right side 5 days ago which had about an 80-90% blockage. Stayed in the ICU for two days until they could get my blood pressure stabilized. Heart rate and BP was running low after surgery. My cardioligist took me off all my high blood pressure medications and I'm being monitored to see when and if my BP gets back to around 150/ so he can start me on probably some new types of BP medications.
Staples should be removed in about 10 more days and hopefully I'll be back to work around that time.
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Nov 3, 2011 @ 11:11 am
my sister has been diagnosed with this problem, she actually has two places in the side of her neck that are blocked. before this dx, she ad a stroke in her eye that was on same side as blockage, she has been heavy smoker for 40 years plus high cholesterol runs in family. dr told her that her chances are better if she has the surgery, instead of leaving it alone, since she already had the eye stroke, she has lost most of her vision in that eye also. she is being operated on by a surgeon thru the VA in Little Rock, Ar, i hope this dr has the same degree of experience as non military doctors. I am really concerned for her. thanks so much for this article, it rings true with everything her doctor told her, which makes me feel better.
Stacie
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Nov 7, 2011 @ 10:10 am
Thank you! I am a STSR Student and this article has greatly helped me with my case study for this term :O)
jean
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Jan 1, 2012 @ 8:08 am
MY HUSBAND IS 75 AND HAS A 90 PERCENT BLOCK ON THE RIGHT SIDE OF NECK AND 30 ON THE LEFT. THEY CAN NOT OPERATE BECAUSE IT HAS GONE UP TO FAR. THEY SAY HE HAS HAD A STROKE ON THE RIGHT SIDE BUT THE ONLY THING THAT HAS BOTHERED HIM IS TINGLING IN HIS RIGHT HAND AND
NUMBNESS IN THE RIGHT SIDE OF HIS LIP. COULD YOU TELL ME WHAT IS TO BE EXPECTED ??
c larson
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Jan 4, 2012 @ 8:20 pm
had endarterectomy 4 weeks ago, my jaw is still numb and now I am having pain by my collar bone and around to myshoulder blade. Is this normal?? my surgeon said to come back 3 months post op should I call him sooner?
R TOMLINSON
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Feb 2, 2012 @ 2:14 pm
HI
I HAD A ENDARTERECTOMY 6 WEEKS AGO MY JAW IS STILL NUMB AND NOW I HAVE GOT A VERY BAD PAIN IN MY SHOULDER BLADE AND COLLER BONE ,
IS THIS NORMAL
Vicki
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Feb 9, 2012 @ 5:17 pm
Feb. 9, 2012 About 6 months ago I had my knee cap replaced. While I was under I was told I was in distress due to a clogged. When I awoke, I was going to have my carotid taken care of. About 2 weeks later They did the surgery, when I woke from the surgery , I found I had no voice.It' now almost 4 month's later, and I only have a whisper of a voice, and have sinus drainage and coughing and choking. 24/7. Can I hope for any hope for any relief in the futher. The doctor that did the surgery just laughs and tells me to be patient.
sandee
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Mar 26, 2012 @ 10:22 pm
How long will it take, after the surgery, to recover? I am planning to move from one State to another?
perry
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Apr 29, 2012 @ 10:10 am
just had carotid doppler, right common carorid -no flow, right internal carotid - no flow, right external carotid -no flow, right carotid bulb - no flow, left side ok, what do I need to expect from MD's and how long would the recovery be for such a procedure? could stenting be options for these types of flow problems? I work out at gym and have been in perfect health for 60 years, have stopped using the protein shakes for body building, really concerned yet not panicking so far, THANKS for your advice.
blake
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May 22, 2012 @ 5:05 am
My father had this surgery and when he was brought out of the anesthesia is was discovered that he had had a massive stroke during the operation. He died two days later. His blockage was 70% and he had had a TIA a few weeks prior to surgery. The surgeon told us that the blockage extended farther up the neck than expected and that the artery had to be tied off. My question is WHY did he not know the extent of the blockage before surgery. The article above states that patients with blockage extending far up the neck to areas not easily accessible are NOT good candidates for this operation. I will be investigating to find out if sufficient testing was done to determine the extent of the blockage. This procedure was performed at Kaiser Permanente.
robin truskett
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Jun 2, 2012 @ 11:23 pm
I found that having the endarectomy with patch in a leading Sydney hospital 4 weeks ago, with a local anaesthetic, was much more traumatic than having my 2 hip replacements last year. I am 70 years old and a retired registered nurse, so thought I knew what to expect. I still have a very swollen incision, some vocal problems and a numb neck. The only saving grace is that it's better than having a stroke!
deb
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Jul 8, 2012 @ 8:20 pm
MY 78 YEAR OLD MOM HAD CARTOID ARTERY SYRGERY ON THE RIGHT SIDE 5 WEEKS AGO. HER VOICE HAS NOT RETURNED. SHE SOUNDS LIKE SHE HAS BRONCHITIS ALL TIME. IS THIS NORMAL OR DO WE NEED TO CONSULT THE SURGERON AGAIN? HE SAID THERE WAS NO CUTS MADE TO CORDS OR BOX
Kim A
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Jul 10, 2012 @ 9:09 am
My father-n-law had this surgery a month ago. His voice, etc is fine. However, he has uncontrollable shakes in his hands now. He wasn't like this before the surgery. What could be causing this?
Frank DeBilio
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Jul 14, 2012 @ 6:06 am
Having had a major stroke in 1997, then had right carotid done. recently had a TIA. The artery had closed up again. recently had left side carotid done. Very informative article.
Aidan Coleman
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Aug 15, 2012 @ 12:00 am
My neighbour Bill here in Dublin Ireland had a carotid endarterectomy right side in March this year.
No history of stroke.
He is worried that since the operation 5 months ago his neck is constantly numb
from the right side of the neck all around the back to the left side neck
and up from under his right ear to the top of his head.
It is very numb on awakening after sleep and reduces somewhat as the day progresses but never goes away.

Your comments and advices will be much appreciated.
mick gittoes
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Sep 17, 2012 @ 9:09 am
how soon can I fly after a carotid endarterectomy. thanks
Sunil Mirji
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Oct 20, 2012 @ 12:12 pm
My Dad was underwent Left Carotid Endarectomy 3 years ago and during surgery he met with a massive stroke. His physical disability revived by 75% within 6 months. But his speech, eyesight and cognitive skills got affected. After the endarectomy, the stitches opened up and blood leaked outside the area causing clot which had to be removed separately. It has been 3 years since the surgery and till now he complains about severe neck pain on opearated area. Consulted many surgeons - performed many angiograms - but nothing showed up. Last doctors concluded that his brain is sending false signals about the pain to that area and that is the reason for the pain. Biggest question is - how do we solve this mystery..? We are unable to find the actual reason behind the pain, and if it is psychological then what is the solution to this?? Any experts in this field - i request your advice. Help is greatly appreciated..
Deb Stafford
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Oct 29, 2012 @ 12:00 am
My Mum is having the operation as I type this. Her right side 75% blocked. She had a minor stroke approx 3 months ago. Mum was also told that there was a fairly high risk that she will have a stroke during or shortly after the op. He also advised her that he could guarantee if she did not have this op that she will definitely have a major stroke in the future. I am very scared at the moment for her.
andrea
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Oct 29, 2012 @ 6:18 pm
hi, my mum has carotid artery disease and waiting to see a neurologist, i was wondering if anyone knows if she will stop going dizzy and regain from blurred vision an being confused, does anyone know.
Junkie N
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Mar 6, 2013 @ 6:18 pm
Just had the carotid endarterectomy 4 weeks ago and this is worst to get over than my heart bypass surgery. Would not recommend to anyone.
4 weeks later and still getting loads of pain and the numbness in my neck and face is so unreal, like I'm been hacked at all the time and having muscular spasms as well.
Love to hear from more people who have recently had same done
ELVI
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Mar 26, 2013 @ 1:01 am
WILL LOST VOICE EVER RETURN.
4 MONTHS SINCE LEFT ENDARTERECTOMRY.
STILL CANT SPEAK ABOVE WHISPER.
RIGHT DONE 15 YEARS AGO WITHOUT AMU PROBLEM.
Lars
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Apr 8, 2013 @ 9:21 pm
Had L/side done mar14. Pain in ear and under ear lobe when putting food or drink in my mouth,.L/Jaw is numb and L/face is like sunburn tender. Difficuly to touch or shave.Awaken every morning with earache.L/muscle in upper L/chest and L/neck does not move.Was this caused by a stroke during surgery or damage done to them nerves at the time of the surgery.
cam
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Jun 8, 2013 @ 9:09 am
I had left side done in April 2014. Have neck pain-and head aches. I have 80% blockage in the right sude and will have another doppler. Does this lack of mobility go away.?
sue appleyard
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Jul 8, 2013 @ 12:12 pm
had right endarterectomy on 21st june, by teatime my neck feels like a ton weight on right side, find eating takes longer and sharp pains occur anytime, hard areas down scarline and wound started oozing since post day 10, otherwise have to be thankful found problem now as was having various symptons that i was not taking seriously. just hope artery doesnt fur up again for a long time and to keep check on the other side.
denise
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Jul 25, 2013 @ 3:15 pm
hi i had left corotid artery op 5 weeks ago im have pain in shoulder blade and collar bone different from right side im unable to lift my arm above waist levelfrom the side has anyone else got theses problems thank you
Robert Pavin
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Sep 25, 2013 @ 10:22 pm
My husband had his carotid artery on the left side 8 days ago and he started swelling up a lot today. Very concerned. Should we call 911
sarah
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Dec 22, 2013 @ 6:18 pm
i had a Carotid Endarterectomy friday 12/20/13 been doing ok but anyone know how long it takes for the swelling to go down?hurts to eat but drinking ok...
julie
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Jan 29, 2014 @ 11:11 am
I had surgery November 26 on my right side. My neck, face and ear on that side are still numb and problematic. Anyone got an idea how long to expect this? I have a 3 month check next month. Both left and right were over 95% blocked and the left should be done in about a year. This surgery, and I have had several different surgeries in my 58 years was one of the most horrid experiences I have had. I am no wimp. Was in the hospital 6 weeks with multiple trauma after a vehicle accident 12 years ago so have had my share of pain.
ron
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Feb 17, 2014 @ 1:13 pm
a lot of negative comments; are there any positive?
Sue
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Mar 23, 2014 @ 10:22 pm
My mother had carotid artery surgery 5 months ago. She developed fluid in a lung following the surgery and one month later was hospitalized with pneumonia and a blood infection. She has numbness in her. jaw and neck and her voice is weak and hoarse. She also complains of a feeling of tightness in her throat as well as pain in her neck and shoulders. Can anything be done about the numbness and problem with her voice? She is getting very frustrated.
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Jun 5, 2014 @ 7:07 am
My Husband had carotid endarterectomy procedure and 5 days later started to bleed out in his neck. They found a surgical sponge was left inside and could have punctured the artery. The insurance is now saying that this could be normal from the surgery. My question is can a hematoba happen 5 days after the coratid endarterectomy?
Stan Neumann
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Jun 28, 2014 @ 9:09 am
TIA @ age 68yrs,57days. Ultrasound w/Doppler showed abnormality; follow-up CTA awaiting surgeon's decision. Reading this article will allow informed conversation w/the surgeon. Thanks, SgN
Jeffre Johnston
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Jul 27, 2014 @ 4:16 pm
how long before my body stops getting high bp spikes after carodic artery surgery. it has been 2 1/2 years
since surgery. otherwise I feel fine

Thank you
Jeffrey Johnston
Janice Kalter
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Aug 7, 2014 @ 5:17 pm
I had carotid endarterectomy the end of April of this year (2014). My left artery was 99% blocked. My face on left side was swollen and numb and to some extent still is. My lower lip on right side droops. I am seeing a second neurologist this month because the first said lip problem had nothing to do with surgery which is not true as everything was normal before surgery. I'm surprised to find that doctors really don't want to give you much information so I'm asking for my medical records. I had no pain or problems after the surgery as some people have but I want to know if the swelling, numbness and lip issues are transient or permanent.
Sherrill Ferrera
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Aug 12, 2014 @ 2:14 pm
I had surgery on my right carotid two years in December. I am experiencing swelling off and on in that area. I had surgery on my left side three years ago and it is finally back to normal. When can I expect this right side to be back to normal? .
MARY
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Sep 30, 2014 @ 7:19 pm
Had my left carotid artery done one month ago and my blood pressure is still off the wall. It runs 224/117 every evening. My neck swells and is numb and my eyes water and I feel like there is a fist in my jaw. My jaw is numb. I had a twist and a kink in my left. My cholesterol was perfect and my blood pressure was great before surgery. Can someone tell me who I should see to help with the blood pressure! My surgery seems to not be concerned. He said it will eventually get better, but I am 67 and very active and still work. This is miserable right now. Any advice?
kj
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Oct 27, 2014 @ 1:13 pm
I had left carotid endarterectomy 6 weeis ago, I had 80% stenosis & 4 Tiabefore they kept me in for emergency surgery.. 4 week's after, I've had terrible dizzy spells n similar symptoms that I had b4 op! Apparently, it's my imagination, altho my right foot had been agony since.. I get pain over my scar n my neck's still very numb. I have my 6 week check this Friday after another Doppler scan on,Thursday. I hope I get all clear but I am slightly anxious in case op wasn't as successful as 1st thought?
Carolyn Bright
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Oct 27, 2014 @ 5:17 pm
i had this surgery one month ago, neck is still sore. main problem is the weakness in legs, no engergy a all. how long will this last? very hard to do anything because of total weakness.

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