Assoc. Prof. Dr. İlker Kiriş
Cardiovascular Surgery
Carotid Artery Surgery
Patients with carotid stenosis or occlusion are diagnosed by performing various examinations after the disease history is taken in detail. These examinations consist of carotid ultrasonography and carotid angiography. Ultrasonography shows the blood flow velocity and form in the carotid artery, as well as the degree of narrowing in the vein.
However, the angiography designates the exact point of the narrowing and the atherosclerotic plaque size that causes the narrowing. Thus, a definitive diagnosis can be made, and a treatment plan can be drawn up. Angiography can be performed in the form of classical (conventional) angiography or the form of computed tomography or angiography accompanied by magnetic resonance imaging. Atherosclerosis, or atherosclerosis, popularly known as arteriosclerosis, which causes carotid artery disease, commonly involves the arteries in the body. Most patients with severe stenosis in the carotid artery may also have stenosis in the coronary vessels in their heart. Therefore, coronary angiography may be planned for these patients because these examinations may require both heart and carotid artery surgery to a certain extent for this patient group.
Why Is Carotid Artery Surgery Necessary?
In patients with severe stenosis in the carotid artery, the plaque that causes stenosis might be torn, and its substances and clots in its content might create embolism in the brain through the blood flow. Also, occlusion may develop in the carotid artery itself as a result of the clot. If these things happen, the patient may develop various degrees of neurological symptoms, paralysis, and he/she might even die. In other words, if a patient who is recommended surgery after careful evaluation by doctors due to severe stenosis in the carotid artery does not agree to undergo surgery, he/she would be at risk of paralysis in the future. The surgery aims to remove the plaques that cause stenosis in the carotid artery and protect the patient from a possible stroke risk.
Which Patients are Suitable for Carotid Artery Surgery?
As a result of the examinations, the complaints from patients with a stenosis of more than 50% in the carotid artery, and other factors are evaluated and a decision is taken on the surgery. Whether the patient has neurological symptoms or complaints is considered. Among these complaints are a temporary paralysis in the form of dizziness, vision loss in the form of cataract in the eyes, inability to speak, weakness in the arms or legs. When deciding on the surgery, no severe stenosis in the coronary vessels that feed the patient's heart tissue must be ensured. Coronary angiography can also be performed when necessary. In some patients, carotid angiography can detect 100% occlusion of the carotid artery. If this blockage is not deriving from a clot formed very recently, that is if it has been there for a long time, no intervention is made on the carotid artery.
How is the Carotid Artery Surgery Performed?
Carotid artery surgery is an effective surgical operation performed in patients with severe stenosis. We can argue that these operations remove vascular occlusion and reduce the risk of paralysis and death. Surgery can be performed under general anesthesia or local anesthesia. After a skin incision on the related side of the neck, the carotid artery stenosis is reached. The carotid artery is temporarily closed with surgical clamps. It opens with an incision in the carotid wall, and the plaque that causes stenosis is removed. It closes with a cut patch on the carotid wall or by stitching it up directly. Then the clamps are removed, stitches are put in the skin, and the surgery is completed. After the surgery, the patient is discharged usually on the second or third day.
Removal of carotid artery occlusion with open surgery is much effective than all other methods. However, there is a connection between the operation's success and its performance by an experienced surgeon. Assoc. Prof. Dr. İlker Kiriş exerts efforts to provide you with the best about examining, diagnosing, and treating carotid artery occlusion. You can make an appointment by contacting our doctor in Izmir province immediately.
