About Carotid Revascularization
The carotid arteries supply blood to your brain and face. A buildup of waste material called plaque can narrow these arteries and reduce blood flow. Doctors use carotid revascularization to open up the area inside the carotid artery at the site of the blockage to reduce the risk of stroke or to prevent further complications from stroke.
Neurosurgeons of New Jersey perform two kinds of carotid revascularization: carotid endarterectomy and carotid angioplasty/stenting. Carotid endarterectomy is the surgical removal of plaque. Carotid angioplasty/stenting involves opening the blockage with a balloon and the permanent placement of a mesh tube inside the artery. Both procedures are widely used in medicine.
Goal of Carotid Revascularization
Successful carotid revascularization restores optimal blood flow to the brain, reducing further risk of stroke.
How Carotid Revascularization is Performed
You will have a different patient experience depending on the type of carotid revascularization you receive. Carotid endarterectomy involves an incision at the site of the blockage, but during carotid angioplasty/stenting doctors navigate a catheter through your body starting with a small incision in your leg.
In general, carotid endarterectomy is performed under general anesthesia. Your doctor will access the carotid artery through an incision in your neck. He or she will place a catheter in the artery during surgery so blood continues to flow to your brain. Your doctor will cut open the artery and remove the plaque. Your surgeon will then remove the catheter and close up the artery and the incision in your neck.
Carotid Angioplasty Stenting
Before the procedure, your medical team will use imaging tests to determine an exact location of the carotid artery. Since the doctor will place a catheter into your body through a small cut in your groin, this area will be shaved and prepared with antiseptic. You will receive medication to numb this area.
During the procedure, the doctor will create a small opening at the site of a major artery in your groin. He or she will place a small tube and catheter into the artery and move it through your body to the carotid artery. The doctor will put a filter just past the blockage so any waste material that comes loose does not escape.
A balloon is placed at the site of the blockage. The balloon is inflated, increasing the size of the passageway through the artery. The doctor then places a small mesh tube, called a stent, to keep the artery open. Once this is complete, the doctor removes the filter, tube and catheter.
Recovery Timeline for Carotid Revascularization
Those who receive angioplasty stenting may have to remain lying down in order to prevent bleeding from where the catheter was inserted. It is common to experience bruising and pain at the site of the catheter incision.
Endarterectomy patients may have a drain in their neck for several hours to relieve built up fluid. While still in the hospital, patients may have ultrasound testing to ensure the artery is clear. Medical teams will keep a close watch for any signs of bleeding or stroke after endarterectomy.
Patients who undergo carotid revascularization generally are closely monitored in the hospital for about 24 – 48 hours, regardless of which procedure they receive. This is to make sure that the brain can adjust safely to the newly restored blood flow that it is receiving following the procedure. After discharge, you may be advised to avoid strenuous activity for a few days and take over-the-counter pain medications such as acetaminophen.
Your doctor will discuss lifestyle changes to prevent the future buildup of plaque, such as diet and exercise. Some patients have annual imaging tests taken of their artery to ensure the plaque has not come back.
Why Choose Neurosurgeons of New Jersey?
The medical team at Neurosurgeons of New Jersey is dedicated to high standards of patient care. While these procedures may be routine for our doctors, we know they are stressful for you and your loved ones. We are committed to remaining open and communicative with you at all times so you feel comfortable asking any questions you may have.