Our Summary

This research paper is about a specific type of surgery called Carotid endarterectomy (CEA), which is often carried out on patients who are at risk of having a stroke due to severe blockage in the carotid artery in their neck. One of the risks of this surgery is that it might lead to complications due to insufficient blood supply to the brain. Therefore, it’s crucial to keep the patient awake during the surgery. Instead of using general anesthesia that puts the patient to sleep, regional anesthesia techniques can be used that only numb a specific area. In this paper, the authors talk about their successful use of a specific regional anesthesia technique, guided by ultrasound, to numb the area around the carotid artery during CEA surgery.

FAQs

  1. What is a carotid endarterectomy surgery and who is it performed on?
  2. What risks are associated with carotid endarterectomy surgery?
  3. Can regional anesthesia techniques be used during carotid endarterectomy surgery instead of general anesthesia?

Doctor’s Tip

One helpful tip a doctor might tell a patient about carotid endarterectomy is to follow all pre-operative instructions given by the surgical team, such as fasting guidelines and medication management. Additionally, it is important to inform the surgical team of any allergies or medical conditions before the procedure. Following post-operative care instructions, such as proper wound care and medication management, is also crucial for a successful recovery.

Suitable For

Typically, patients who are recommended for carotid endarterectomy are those who have significant blockages in their carotid arteries, leading to a high risk of ischemic stroke. These patients may have symptoms such as transient ischemic attacks (TIAs) or mini-strokes, as well as a history of stroke or other vascular diseases. Additionally, patients who have severe carotid artery stenosis, particularly those with narrowing of 70% or more, may be candidates for CEA surgery. It is important for these patients to be carefully evaluated by a vascular surgeon to determine if they are suitable candidates for the procedure.

Timeline

Before carotid endarterectomy:

  • Patient undergoes preoperative evaluation, including medical history, physical examination, and imaging studies
  • Patient may be given instructions to stop certain medications prior to surgery
  • Anesthesia team discusses anesthesia options with the patient, including general anesthesia or regional anesthesia techniques
  • Patient may undergo a carotid sheath block procedure under ultrasound guidance for regional anesthesia

During carotid endarterectomy:

  • Patient is monitored closely during the surgery, including blood pressure, heart rate, and oxygen levels
  • Anesthesia team administers anesthesia as planned, either general anesthesia or regional anesthesia
  • Surgeon performs the carotid endarterectomy procedure, removing the plaque from the carotid artery to improve blood flow to the brain
  • Patient may be awake during the surgery to monitor neurological function and prevent ischemic complications

After carotid endarterectomy:

  • Patient is closely monitored in the recovery room for any complications, such as bleeding or neurological deficits
  • Patient may stay in the hospital for a few days for observation and recovery
  • Patient may be given instructions for post-operative care, including pain management, activity restrictions, and follow-up appointments
  • Patient may undergo rehabilitation or physical therapy to improve strength and mobility after surgery.

What to Ask Your Doctor

  1. What are the potential risks and benefits of carotid endarterectomy surgery for my specific condition?
  2. How experienced are you in performing carotid endarterectomy surgeries?
  3. What type of anesthesia will be used during the surgery and why?
  4. What is the success rate of carotid endarterectomy surgery for patients with similar conditions to mine?
  5. What is the expected recovery time and follow-up care after the surgery?
  6. Are there any alternative treatment options to carotid endarterectomy that I should consider?
  7. What are the potential complications or side effects of carotid endarterectomy surgery?
  8. How long will I need to stay in the hospital after the surgery?
  9. What is the long-term prognosis for patients who undergo carotid endarterectomy surgery?
  10. Are there any specific lifestyle changes or medications I should consider after the surgery to reduce the risk of future complications?

Reference

Authors: Yildiz Y, Çiftçi B, Ekinci M, Demiraran Y. Journal: Agri. 2023 Jan;35(1):50-52. doi: 10.14744/agri.2021.56987. PMID: 36625192