Stroke after carotid endarterectomy
Common Questions and Answers about Stroke after carotid endarterectomy
stroke
Hi,
Once an ischemic stroke is completed, surgical removal of atheromas or clots (endarterectomy) in an internal carotid artery may be done. Carotid endarterectomy can help if all of the following are present: The stroke resulted from narrowing of a carotid artery by more than 70%.,Some brain tissue supplied by the affected artery still functions after the stroke,The person's life expectancy is at least 5 years.
I mean to - Carotid endarterectomy , which is - Carotid Artery Surgery.
Do you if this is more or less risky compare with stenting ?
I am not sure that this is considered as a brain surgery. Is it ?
I just want to undersatnd what is less or more risky - Carotid Artery Surgery or Carotid Artery Stenting.
The usual method for treating a carotid artery was/is a endarterectomy procedure. This involves opening the artery and removing the plaque with special tools. However since stents were invented, they seem to be getting used everywhere now. In kidneys for example, the long term outcome doesn't exactly look promising. In carotid arteries they seem to produce more strokes and heart attacks than the usual procedure.
Delaying surgery longer than 2 weeks increases the risk for stroke, because people are more likely to have a stroke in the first few days and weeks after a first stroke or a TIA.
The likelihood of complications from carotid endarterectomy varies, depending on the skill and experience of the surgeon.
I went through a left carotid endarterectomy while my right carotid was 100% occluded. I had no TIAs nor did I have a stroke ( which frequently happens right when the artery closes completely.)
My right carotid was checked via Doppler ultrasound and was deemed 65-70% occluded. The Dr opted to do the endarterectomy anyway. He found that the carotid was actually about 85% occluded !
Treatment for carotid artery stenosis is often addressed by a vascular surgeon -- who might perform a carotid endarterectomy to remove the blocked areas of the vessel. This is often done (if severe) in patients prior to open heart surgery to minimize the risk of further complications such as stroke.
My mother is 79 years old and 280 pounds she has high blood pressure and is a diabetic. She had a massive stroke 10 days ago on the right side of her brain. Her right carotid artery was tested and is 100% blocked while she lost control of her left side including the sight in her left eye, her current and pass memory are excellent. I understand surgery is out of the question. She is still in the hospital and they have her blood sugar and blood pressure under control.
Has anyone experienced damage to the Vargus or Glossopharyngeal nerve and loss of swallowing and gag reflex after carotid endarterectomy surgery? I am interested in learning more about what treatments you may have had and the results.
NASCET = North American Symptomatic Carotid Endarterectomy Trial. NASCET trial proved the benefits of performing endarterectomy in those patients with symptomatic high-grade stenosis.
0-49% = mild stenosis
50-69% = moderate stenosis
70-99% = severe stenosis
Your 70% stenosis would warrant intervention.
68 year old male, main complaint of extreme fatigue, diagnosed with 70 % occlusion of R carotid---endarterectomy in Sept of 2008 ; MRI showed 3 strokes (only symptom of stroke was numbness in L hand).
Now post-op 6 months, all heart stress tests and head scans are WNL and fatigued is less but still a major problem. Additional symptoms are profuse salivation while eating (I know that sounds funny, but I choke!) as well as excessive tearing of L eye.
s suffering from stroke like conditions that can be a direct consequence of the carotid blockage (since this is the major blood supply to the brain). She might need invasive procedures such as embolectomy, or carotid endarterectomy to clear out the obstruction.
I hope that once you are able to bring her to her doctors, everything will turn out OK.
Wishing your grand mother all the best. Take care and God bless.
Two years ago, we found my husband's right carotid was 100% blocked and probably had been "for some time". At the same time, the left carotid had a less than 75% blockage. The cardiologist said the right could not be bypassed or repaired in any way, and he said that repairing or bypassing the left side was not a good idea.
I had a left side carotid endarectomy 2 days before Christmas. All of my symptoms started after the surgery, like the day after, the sore throat was there when I woke up in ICU. I saw my family doctor, the surgeon who did the endarterectomy and an ENT locally, all said my symptoms were due to the endarterectomy. The first ENT I saw did a scope of my throat and said all was well. Now I have this doctor saying it's throat cancer.
what amount of time should be allowed for scheduling surgery after being diagonised with 90% blocked carotid artery
It's been almost a year since I had an endarterectomy of my right internal carotid artery. It is very sore still and feels swollen. Sometimes it feels like a pulling sensation and like a lump in that side of my throat, Has anyone else experienced anything similar?
We created the operation for carotid blockage, carotid endarterectomy. Regardless of who you see,make sure that they do high volume of whatever treatment is recommended.
There is a high risk of stroke with carotid artery stenosis and although the blockages are not severe (although 69% is pretty close), that risk remains. Aspirin will help to some extent but usually something stronger is added to this to ensure clotting risk is kept to a minimum. I too would feel concerned and for the sake of a 1% difference, they are not taking intervention measures. There are two possible options for your carotid disease with regards to intervention.
max peak systolic velocity of the internal carotid artery is 108 cm/s. max peak systolic velocity of the external carotid artery is 128 cm/s
L-demonstrates irregular plaque formaton.
common carotid 113 cm/s
internal carotid artery 97 cm/s
external carotid artery 111 cm/s
Vertebral arteries demonstrate normal flow & direction bilaterally
R carotid system moderate atherosclerosis is present, less than 50% in the internal carotid artery.
My husband had an carotid endarterectomy a month ago. He has a cough now everytime he lies down. The cough is dry and unproductive. Lately the cough at night causes him to feel like he is gagging or choking but when he sits up to cough he only gags and coughs and there is no sputum. Last night he said this happened six times. He is not nauseated but sometimes his stomach hurts.
There are two options usually considered and these are an endarterectomy or stenting. With an endarterectomy, general anaesthesia is usually used, an incision is made in the neck to access the artery and this is opened up so the material causing the blockage can be removed. The risks with this procedure are damage to nerves which run very close to the carotid artery.
I assume you are referring to the coretid arteries in the neck?. Carotid endarterectomy is one of the most commonly performed vascular operations, and is a safe and long-lasting treatment.
The procedure is to either put to sleep or an anesthesiologist or surgeon can numb your neck area and keep pt awake so one can communicate with the surgeon during the operation. By staying awake, pt may help the physician monitor pt's brain reaction to the decreased blood supply.
for those vessels we commonly use prosthetic which is very durable. For a carotid endarterectomy, prosthetic is used 95% of the time.
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