The carotid arteries are located on either side of the neck and are the major arteries that supply blood to the head and neck. A carotid plaque can accumulate in these arteries, causing the formation of a space or complete blockage and impairing blood flow to the brain.
Surgery to remove a carotid plaque is typically recommended for patients who have experienced a transient ischemic attack (TIA) or a minor stroke (CVA) due to significant carotid artery disease. The surgery helps prevent future stroke incidents.
In some cases, the surgery may be performed even without symptoms when there is a significant buildup or severe blockage of the carotid artery, posing a risk of a brain embolism. In such cases, part of the carotid plaque detaches and moves with the blood flow, entering the brain's blood vessels and obstructing blood supply to brain cells. Such an embolism can lead to a stroke. The decision for surgical treatment should be made on an individual basis by the patient and the surgeon.
Like any surgery, there are risks of complications, including bleeding, infection, blood clots, brain damage, heart attack, or stroke. The risks of the surgery vary depending on the severity of the disease, the location of the blockage, and the patient's medical history. Special precautions are taken to minimize these risks. Prior to the surgery, the patient meets with a vascular surgeon who explains the procedure in detail and answers questions.
The surgery is performed under general anesthesia through an incision above the area of the blockage in the carotid artery. The risk of a stroke during the surgery is reduced by redirecting blood flow to the brain through a plastic tube. Then, a cut is made along the part of the artery where the carotid plaque is located, and the plaque is removed. In some cases, unhealthy parts of the blood vessel are also removed. After removing the plaque, the surgeon closes the incision with sutures, and then removes the temporary bypass tube, allowing blood flow to return to its normal path in the brain.
The surgery usually lasts about two hours and is generally well-tolerated by most patients. Recovery from the surgery is rapid, and most patients are discharged home the next day. Some discomfort in the surgical area may occur, but it is typically controlled with painkillers.
Results of the surgery
For most people, the surgery helps prevent further brain damage and reduces the risk of disability from a stroke. However, the patient needs to adopt a healthy lifestyle to minimize the chances of plaque accumulation and recurrent blood clots.