A carotid endarterectomy removes plaque from arteries and lowers the chance that you will have a stroke. The procedure’s effectiveness makes it essential for many people. If you plan to undergo a carotid endarterectomy, though, you should learn about some factors that will affect your recovery. The more you know about your carotid endarterectomy recovery, the more likely it is that you can return to your normal life within a short period of time.
What Is Carotid Endarterectomy Surgery?
A leading cause of stroke is carotid artery disease. When plaque — a waxy substance made up of cholesterol and other materials — builds up on the inner walls of the carotid arteries in the neck, the artery can become narrowed or blocked completely so that blood can’t reach the brain. If your carotid artery has plaque blockage of 70 percent or more, your doctors may recommend a carotid endarterectomy to clear the artery and restore blood flow to the brain.
Carotid endarterectomy surgery takes place in a hospital, usually under general anesthesia. During the procedure, your surgeon makes an incision in your neck over the carotid artery, opens the artery and removes the plaque causing the blockage. A shunt may be used to route blood to the brain while the artery is being cleared.
Once the plaque is removed, your surgeon removes the shunt and closes the incision. You can expect to recover in the hospital for a day or so while your care team monitors your condition for any complications from the procedure or problems with your incision.
Carotid Endarterectomy Recovery
At home, your recovery from carotid endarterectomy surgery can take a couple weeks. When you leave the hospital your doctors will provide you with discharge instructions, which include information on caring for your incision, complications to watch out for and directions for taking any medications you may need. Be sure to follow these instructions carefully and give your body time to rest and heal.
You can expect to have some pain and discomfort when swallowing or turning your head, and activities like driving, lifting or any strenuous exercise will be limited during this time. It’s important to have someone available to help you with chores and transportation while you recover. To improve your carotid endarterectomy recovery keep the following tips in mind.
Keep Your Incision Site Clean
Your surgeon will need to make an incision at the front of your neck to perform a carotid endarterectomy. After the surgery, he or she will close the incision site with stitches or adhesive bandages. Once you leave the hospital, you will need to take care of this area to encourage healing.
Cleaning the incision site usually requires nothing more than water and mild soap. Use a soft sponge to wipe away any blood, sweat or dirt that accumulates near your wound. Take care not to apply much pressure to the area. Do not clean the incision with hydrogen peroxide. Hydrogen peroxide can slow the healing process.
After you clean the incision site, dry it thoroughly with a soft towel. You should also pat the area dry after taking a bath or shower. If you wear a gauze or other type of bandage, reapply it after drying the incision area.
Talk to your doctor about ways you can prevent a scar from developing at the incision site. He or she may have some advice that’s unique to your situation.
Avoid Strenuous Activities
Rest plays an important role in carotid endarterectomy recovery. You must avoid strenuous activities until your incision site heals. Most people take one or two weeks off from work so they don’t damage the area. You should also avoid playing sports, carrying heavy items or performing strenuous housework.
You can participate in some light activities during your recovery. Taking a daily walk, for instance, will improve your general health and help you regain strength. You may find that you cannot walk very far at first. That’s fine. Each day will bring a little more strength so you can walk farther.
Since you cannot participate in strenuous acts during the first few days of your recovery, it makes sense to have a companion stay with you. Otherwise, you may feel tempted to do things that will delay your recovery.
Eat a Healthy Diet
You may want to use your carotid endarterectomy recovery to improve your diet. It’s best to eat a low-fat, low-sugar diet that includes plenty of protein.
Try not to skip meals during your recovery. Your body needs calories to mend itself and regain strength. If you don’t have much of an appetite, try eating simple foods like chicken broth or yogurt.
Many people experience constipation after undergoing surgeries. If you have to strain during bowel movements, then you should take a fiber supplement daily. Straining can injure your incision site, so you want to avoid it. If your constipation lasts for longer than two days, contact your doctor.
Use Medications to Control Pain
Your incision site may feel swollen and sore for two weeks or longer, so you might need to take medication to control the pain. Many doctors prescribe medications for this purpose. If your doctor does not think you need a prescription medication, then you should ask about taking an over-the-counter drug.
Do not mix an over-the-counter pain reliever with prescription medication unless your doctor advises it. Mixing drugs can lead to serious consequences that will harm your health and slow your carotid endarterectomy recovery. Always disclose to your doctor what kind of medications you have tried on your own, which may include herbal supplements or other kinds of remedies. If your doctor knows what you have already tried, then she or he may be able to tailor your pain medication more effectively towards your needs.
Follow Your Doctor’s Medication Instructions
Many patients who undergo carotid endarterectomies take prescription medications for health issues like blood clots and heart disease. Some of these drugs may interfere with your recovery, so it’s important to talk to your doctor about whether you should continue taking medications like warfarin and clopidogrel.
Even a relatively benign drug like aspirin could affect your carotid endarterectomy recovery. Make sure you get approval from your doctor before you take aspirin as a blood thinner or pain reliever.
Quit Using Tobacco Products
Using tobacco products often contributes to plaque accumulation in arteries. If you smoke cigarettes or use other forms of tobacco, now is a great time to quit. Giving up tobacco products now will help you recover and avoid future surgeries.
Many medical practices and health insurance companies have smoking cessation programs that can help you quit. Depending on your health, you may also choose to use cessation products such as nicotine gum or prescription drugs.
Your neurosurgeon will want you to quit using tobacco products, but he or she may want you to consider some options over others. Talk to your medical doctor as well about any smoking cessation programs or products that you plan to use.
Managing the Risks of a Carotid Endarterectomy
Carotid endarterectomy surgery is a generally safe procedure that can significantly reduce the possibility of a stroke, but it can have potentially serious risks, especially for people who have chronic health problems such as hypertension, diabetes or other conditions. These risks include:
People who have a carotid endarterectomy have a slightly increased risk of a stroke during or after the procedure. About 2 to 3 percent of people who have not had a stroke before surgery experience this complication. For those who had a stroke or mini stroke, about 5 percent may have a subsequent stroke.
Placing a shunt into the artery during surgery reduces this risk, because it helps keep blood flowing to the brain. Your doctors may also prescribe an anticoagulant medication before surgery to reduce the possibility of developing a blood clot. During your recovery in the hospital, your doctors and care team will monitor you carefully for any signs of a stroke.
Because surgery can be stressful, especially to the heart, people having a carotid endarterectomy face a slightly elevated risk of a heart attack, possibly because people who have carotid narrowing may also have similar narrowings in the heart. To reduce this risk, your care team may advise you to consult a cardiologist before the surgery, and will also closely monitor your heart rate and blood pressure throughout the procedure and during your hospital stay.
The carotid arteries are very close to sensitive nerves related to the movement and functioning of the larynx, tongue, and the neck and back. Those nerves can be damaged during surgery, causing temporary or permanent numbness or loss of some functioning in those areas. If you experience nerve damage, you may be referred to physical therapy and rehabilitation to manage the condition.
New plaque can develop in the carotid artery after a carotid endarterectomy, especially if conditions that contributed to plaque buildup, such as smoking, an unhealthy diet or lack of exercise, still continue. To reduce the risk of new plaque buildup, your doctor may recommend making healthy lifestyle changes or prescribe medications to manage conditions, such as high blood pressure or high cholesterol.
If you feel uncertain about what you should do during your carotid endarterectomy recovery, reach out to your neurosurgeon for more information. He or she can help you make choices that will shorten your recovery timeline, help you avoid complications and contribute to your overall well-being.