Traditionally significant carotid artery stenosis has been treated with a surgical procedure called a carotid artery endarterectomy. The surgery is started with a 4 to 6 inch incision in the neck on the side of the blockage. The blood vessel is identified and encircled with tapes to control for bleeding. A blood thinner (Heparin) is administered to prevent clotting and the artery is clamped to allow a bloodless field. Often times a tube (shunt) will be placed in the artery before the blockage and into the area above the blockage to allow blood flow into the brain while operating on the blockage. The plaque is scraped clear of the normal blood vessel wall allowing for the blockage to be removed. The blood vessel is closed with a suture and the shunt and clamps are released. The incision is closed and the patient is taken to recovery. A patient will often remain in the hospital for one to two days after a carotid endarterectomy until discharge to home.
Recently, balloon angioplasty and stents have been used on carotid artery stenosis. This involves placing a small catheter in the groin to guide a balloon and stent into the area of blockage. The balloon and stent are expanded pushing the blockage aside to restore the normal caliber of the blood vessel.
Keywords: Stroke, High Blood Pressure, TIA (transient ischemic attack)
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