A carotid endarterectomy may be needed if one or both of your carotid arteries become narrowed because of a build-up of fatty deposits (plaque).
This is known as carotid arterydisease or carotid artery stenosis, and it significantly increases your risk of havinga Heat exhaustion and heatstroke or a transient ischaemic attack (TIA) .
Normal healthy arteries are elastic and smooth on the inside, allowing blood to easily flow through them. As a person gets older, plaque can build up inside the arteries, making them narrower and stiffer. This process is called atherosclerosis .
As well as ageing, there are several other factors that can contribute to a build-up of plaque, including:
Theseare described below:
Carotid artery disease is usually diagnosed if a person has the symptoms of a stroke or TIA, such asthe face drooping on one side, numbness or weakness inthe arms or legs, speech problems, or a loss of vision in one eye.
However,narrowing of the carotid arteriesmay be diagnosed if you're having tests for another reason and the doctor testing you notices your arteries are narrowed.This is called an asymptomatic carotid stenosis.
If you've recentlyhad a stroke or aTIA, you'll be referred for some brain imaging tests. This allowsthe blood supply to your brain to be checked and any narrowing in your carotid arteries to be diagnosed.
Severaltestscan beused toexamine your carotid arteries and find out how much plaque has built up inside them. These include:
An ultrasound scanis usually used first to checkif there's any narrowing inyour arteries and to determine whether it's severe enoughfor you to benefit from having surgery.
If your arteries are narrowed, you may need to have further tests to confirm the diagnosis, such as aCTA or MRA.
If tests indicate your carotid arteries are narrowed, theseverity of the narrowing (stenosis) will be graded to determine if you need surgery.
In the UK, the most common grading system used is the North American Symptomatic Carotid Endarterectomy Trial (NASCET) scale.The scale hasthree categories:
The National Institutefor Health andCare Excellence (NICE) recommends that people who have had a stroke or TIA and have a moderate or severe stenosis should have a carotid endarterectomy.
You should be assessed within a week of the start of your stroke or TIA symptoms, and the operation will ideally be carried out within two weeks of when your symptoms started.
It's crucial that you seek medical advice as soon as possible if you develop symptoms of a stroke or TIA. Surgery has the best chance of preventing a furtherstroke if it's performed as soon as possible.
Surgery will sometimes be recommended if you haven't previously had a stroke or a TIA, but you're found to have severe stenosis.
Surgery won't be recommended if you have minor stenosis (less than 50%). This is because surgery has the most benefit for people with moderate and severestenosis (more than50%). The maximum benefitis seen in those with severe stenosis (70-99%).
A carotid endarterectomy isn't of any benefitin people witha complete blockage of their carotid artery.
A carotid endarterectomy is a surgical procedure to unblock a carotid artery. The carotid arteries are the main blood vessels that supply the head and neck.
A carotid endarterectomy may be needed if one or both of your carotid arteries becomes narrowed by a build-up of fatty deposits (plaque).
Before having a carotid endarterectomy, you'll attend a pre-admission clinic where you'll have a physical examination and be asked about your medical history.
A carotid endarterectomy will either be carried out under general or local anaesthesia.
After a carotid endarterectomy, you will usually be moved to the recovery area of the operating theatre or, in some cases, a high dependency unit (HDU).
As with all types of surgery, there are some risks associated with having a carotid endarterectomy.
A carotid endarterectomy is the main treatment for narrowed carotid arteries. However, an alternative procedure called carotid artery stent placement can also be used.
Mr Joseph Leverment, from Cropston, Leicester, had a carotid endarterectomy while he was a senior surgeon at University Hospitals of Leicester NHS Trust.