Reason for Potential Carotid Artery Surgery Examination
Carotid artery disease, a condition that occurs when a sticky substance called plaque builds up inside the artery walls, can increase a person's chances of developing a blood clot. This clot, if it travels to a person's brain, can potentially cause a stroke. To combat this, doctors perform carotid artery surgeries, such as Carotid Endarterectomy (CEA) and Transcarotid Artery Revascularization (TCAR).
Carotid Endarterectomy (CEA) is a surgical procedure to remove plaque from the carotid artery to prevent stroke. It involves making an incision in the neck to access the artery, then physically removing the plaque causing stenosis. Patients typically spend a few days in the hospital after CEA. Recovery includes neck soreness, bruising, difficulty swallowing requiring a temporary soft food diet, and restrictions on activities such as driving until neck movement is pain-free. Medication for pain, blood clot prevention, and control of blood pressure and cholesterol is common. Most patients regain full strength within 2 to 4 weeks post-surgery.
Transcarotid Artery Revascularization (TCAR) is a minimally invasive alternative to CEA that involves placing a stent through a small incision at the neckline, with a unique flow reversal system to reduce stroke risk during the procedure. TCAR is typically performed under general anesthesia or monitored anesthesia care, depending on patient factors. Recovery is faster than CEA; patients usually stay one night in the hospital and experience less pain, smaller scars, and less discomfort. They are advised to avoid heavy lifting or strenuous activity for about a week and are prescribed blood thinners to prevent clots in the stented artery. Return to normal activities and work is guided by the treating physician.
Both procedures aim to reduce stroke risk from carotid artery disease but differ in invasiveness and recovery speed. A doctor may recommend carotid artery surgery for people with artery narrowing of 70% or more, or for those who have had a stroke and have artery narrowing of more than 50%. For TCAR, a surgeon creates a small incision at the neckline, places a tube into the carotid artery, directs blood flow away from the brain, captures material through a filter, places a stent in the carotid artery, and returns blood flow to the normal direction.
After either CEA or TCAR, people typically remain in the hospital for 1-2 nights. A person may be able to eat, drink, drive, and return to work 2-3 weeks, or 3-4 weeks after the surgery, depending on their recovery. It's important to follow the doctor's instructions for wound care and medication, and to avoid strenuous activities for several weeks following surgery.
In summary:
| Aspect | Carotid Endarterectomy (CEA) | Transcarotid Artery Revascularization (TCAR) | |-----------------------------|--------------------------------------------------|-------------------------------------------------------| | Procedure | Open neck incision to remove plaque | Minimally invasive stenting via small neck incision | | Anesthesia | General anesthesia | General or monitored anesthesia care (MAC) | | Hospital stay | A few days | Typically one night | | Recovery | Neck soreness, bruising, swallowing difficulty, restricted activities; recovery ~2-4 weeks | Less discomfort, smaller scars, quicker recovery; avoid heavy lifting 1 week | | Risk | Stroke, heart attack, nerve damage to mouth/throat muscles | Lower stroke and heart attack risk during procedure | | Postoperative care | Pain meds, blood thinners, control of BP and cholesterol | Blood thinners, activity/diet guidance, follow-up care |
Both procedures aim to reduce stroke risk from carotid artery disease but differ in invasiveness and recovery speed. It's essential to discuss the options with your doctor to determine the best course of action for your specific situation.
- Carotid Endarterectomy (CEA) and Transcarotid Artery Revascularization (TCAR) are medical-conditions related to health-and-wellness that address carotid artery disease, a condition that can lead to stroke.
- For neurosurgery procedures like CEA, the process involves removing plaque from the carotid artery by making an incision in the neck and accessing the artery, which can result in side-effects such as neck soreness, difficulty swallowing, and restrictions on activities.
- Science has provided a minimally invasive alternative to open neck surgeries like CEA with TCAR, using a stent and a flow reversal system that reduces the risk of stroke during the procedure.
- In the realm of cardiovascular-health, patients who undergo carotid artery surgeries such as CEA or TCAR may require medication like pain medication, blood thinners, and drugs to control blood pressure and cholesterol for a prescribed duration post-surgery.
