For patients with clinically significant carotid narrowing this is usually treated with a Carotid Endarterectomy.
A carotid endarterectomy is an operation to clear the dangerous atherosclerosis from the carotid artery in the neck, clearing the narrowing and substantially reducing the risk of a stroke.
After careful anaesthetic and monitoring, a 10cm long incision is made in the side of the neck obliquely, and carefully deepened identifying the important nerves. The jugular vein is carefully mobilized and retracted. The carotid artery and its major branches are carefully dissected out avoiding the area of disease. A blood thinner called heparin is given and clamps applied to the artery above and below the disease. The carotid artery is opened longitudinally through the area of disease from normal vessel above and below. A shunt tube is immediately established to allow blood to continue to flow to the brain while the carotid artery is cleared of atherosclerosis.
Under magnification, the carotid artery is cleared of the atherosclerosis and clot (called endarterectomy) and then the remaining surface is carefully inspected and cleared of any loose material. When the surface has been cleaned completely and no loose material remained, the carotid artery is then closed. This is achieved using a patch, usually of prosthetic material called Dacron. This actually makes the artery slightly larger to help prevent recurrent narrowing and reduce the risk of stroke as much as is possible. A drain is placed and the wound closed carefully in layers. Post operatively, careful observations are ordered.
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