Carotid endarterectomy
What is it?
The intervention consists in removing the plaque that causes stenosis to allow the proper restoration of the cerebral flow and prevent the onset of neurological events, sometimes fatal (stroke).
When is this procedure indicated?
It is indicated when the percentage of internal carotid artery stenosis is 70% or greater or if the patient had symptoms suggestive of a cerebral ischemic event (dysastria, amaurosis, steno/sensory deficits in the upper extremities), although the percentage of stenosis was less than 70%.
How is it performed?
The procedure is performed through an incision on the anterior margin of the sternocleidomastoid muscle and progressive isolation of the internal, common and external carotid artery. Subsequently, a cut is made on the artery to allow exposure of the atherosclerotic plaque and its removal. The patient is awake as plexus anesthesia (plexus-cervical) is performed, which allows surgeons to closely monitor if the patient has ischemic events during the procedure. If so, the surgery will continue with the use of a shunt to allow adequate cerebral flow.
Recovery
The length of stay is usually 4 days.
Short-term complications
Stroke, TIA, latero-cervical hematoma with tracheal and/or esophageal detour.
Long-term complications
Infection, wound dehiscence, restenosis in endoarterectomy outcomes.
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