Question 1

can my artery reclog after carotid endarterectomy?

Accepted Answer

Yes: The recurrence rates after endarterectomy depend in a number of factors such as smoking, patch use for angioplasty and on going problems with managing the risk factors of peripheral vascular disease. Women may also be more likely to have recurrent disease.

Question 2

how effective is carotid endarterectomy?

Accepted Answer

Very: We use the endpoint of stroke to define how effective carotid surgery  is. Endarterectomy reduces the risk of stroke from 26% to 9% in patients with high grade stenosis (narrowing) who have had mini-strokes or strokes in the past. In people who have not suffered mini-strokes or strokes but have a high grade stenosis, endarterectomy reduces risk of stroke from 10% to less than 5%.

Question 3

what does it mean to have carotid endarterectomy?

Accepted Answer

Clearing of Plaque: This is to surgically expose the carotid artery in the neck and to remove the plaque of the diseased artery.   Arteries have 3 layers. Plaque / atherosclerosis develops in the inner two layers. The outer layer is the strength layer.  These layers peel apart similar to the layers in an onion. Once cleared, the artery is closed using patch to prevent it from scarring down. The goal: prevent strokes.

Question 4

when can i exercise after carotid endarterectomy?

Accepted Answer

Yes: You can start with gentle excercize after 2 weeks and normal rouotine excercize after 6 weeks. It all depends on your recovery from the surgery.

Question 5

how likely is survival for carotid endarterectomy?

Accepted Answer

Generally good.: Carotid endarterectomy (cea) generally has a low operative morbidity (complication) and mortality (death), and this is because CEA should not be generally offered in patients who are not an acceptable risk and who don't have an adequate life expectancy. Consult with a vascular surgeon to discuss this operation in more detail.

Question 6

what is recovery like after carotid endarterectomy?

Accepted Answer

One Night Stay: Typically people spend one night in the intensive care unit before going home the next day. A sore throat is common as is numbness of the neck / chin / lip of the operated side. The numbness improves over 6 months.  Pain is surprisingly not the most common complaint. High or low blood pressure, the complication of stroke or a heart attack may keep a patient in the hospital longer.

Question 7

any lethal complications to carotid endarterectomy ?

Accepted Answer

Plenty: Most dreaded complication is a stroke, and a minority of these can be lethal. In some patients, bleeding in the surgical bed can lead to a collection of blood/fluid that generate enough pressure to impair airway function, this is a life threatening condition. Heart attacks, pulmonary emboli and arterial dissection can also happen, but fairly rairly.

Question 8

what are the chances of survival after carotid endarterectomy?

Accepted Answer

Depends on details: In general, experienced surgeons can perform endarterectomy with low complications. Many surgeons have a 2% peri operative rate of stroke, less than 1% risk of peri operative death. There is some risk to nerves that control the voice box but should an injury occur it is usually temporary. The key is to ask your surgeon what his personal complication rates are.

Question 9

how long does it usually take to recover from carotid endarterectomy?

Accepted Answer

3-6 weeks: I have had patients return to full activities 3 days later and have never had anyone take more then 6 weeks.  Most are fully recovered by 3 weeks.  I have done over 2500 carotid surgeries.

Question 10

what is a carotid endarterectomy consist of?  they cut open your carotids?

Accepted Answer

Plaque removal: It is a technical operation. Artery is controlled, opened under full anticoagulation. Shunt placed to maintain blood flow to your brain and the lesion removed. If the artery is small caliber a patch can be used to increase caliber or close artery primarily. For my patients, I photograph the plaque for them.

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What is a carotid endarterectomy consist of? they cut open your carotids?

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