Minimally Invasive Surgery with Carotid Endarterectomy:

The operation of carotid endarterectomy is used to treat carotid artery disease. When fatty, waxy deposits form in one of the carotid arteries, this illness develops. Each side of your neck has carotid arteries, which are blood vessels (carotid arteries). Plaque accumulation (atherosclerosis) can obstruct blood flow to the brain. Removing the plaque that is restricting your carotid artery can increase blood flow and lower your risk of stroke.

A local or general anaesthesia is used during carotid endarterectomy. Your surgeon will create an incision across the front of your neck, open your carotid artery, and remove the plaques that have clogged it. The artery is then repaired with stitches or a vein patch or artificial material (patch graft) by your surgeon.

A method known as eversion carotid endarterectomy is sometimes used by surgeons. This procedure entails severing the carotid artery and turning it inside out, followed by plaque removal. The artery is then reattached by your surgeon.

Disease Overview

A narrowing of the major arteries on each side of the neck is known as carotid artery stenosis. Blood flows through these arteries to the head, face, and brain. This constriction is frequently caused by plaque buildup in the arteries, a disease known as atherosclerosis. Fatty deposits (plaques) block the blood vessels that provide blood to your brain and skull, causing stroke (carotid arteries). The obstruction raises your chances of having a stroke, which occurs when the blood flow to the brain is cut off or severely diminished.

Carotid artery disease takes time to develop. A stroke or transient ischemic attack may be the first symptom that you have the illness (TIA).A transient interruption of blood flow to the brain is known as a TIA.

Disease Sign and System

Carotid artery stenosis sometimes has no symptoms or indicators in its early stages. The disease may go undiscovered until it becomes severe enough to deprive your brain of blood, resulting in a stroke or transient ischemic attack (TIA).

The following are signs and symptoms of a stroke or TIA:

1. Sudden numbness or paralysis in the face or limbs, usually on just one side of the body 
2. Sudden difficulty speaking and comprehending 
3. Sudden difficulty seeing in one or both eyes
4. A strong headache that appears out of nowhere.
   

Disease Causes

Factors that increase your risk of carotid artery disease include:

- High blood pressure: Excessive strain on artery walls might weaken them and expose them to injury.

- The usage of tobacco: Nicotine might irritate your arteries' inner lining. Smoking also raises your blood pressure and heart rate.

- Diabetic complications: Diabetes impairs your capacity to properly metabolise lipids, increasing your risk of high blood pressure and atherosclerosis.

- Excessive fat in the blood: The building of plaques is aided by high levels of low-density lipoprotein cholesterol and triglycerides, a blood fat.

- A family history: If a family member has atherosclerosis or coronary artery disease, you're more likely to have carotid artery disease.

- Your age: With ageing, arteries become less flexible and more vulnerable to damage.

- Obesity: Excess weight raises your risk of hypertension, atherosclerosis, and diabetes.

- Obstructive sleep apnea: Stopping breathing for long periods of time at night may raise your chance of a stroke.

- A lack of physical activity: It leads to artery-damaging disorders such as high blood pressure, diabetes, and obesity.

Diagnosis

A comprehensive medical history and physical examination are likely to be the first steps taken by your doctor. A swooshing sound (bruit) across the carotid artery in your neck, which is indicative of a restricted artery, is usually heard during the test. The strength, memory, and speaking abilities of your body and mind may be tested by your doctor.

Following that, your doctor may suggest:

- An ultrasound examination of the carotid arteries to determine blood flow and pressure.

- A CT scan or an MRI scan to check for signs of a stroke or other abnormalities.

- A CT or MR angiography scan of the carotid arteries, which offers additional pictures of blood flow. A contrast dye is injected into a blood artery, and pictures of your neck and brain are collected using a CT scan or an MRI.

Disease Treatment

The goal in treating carotid artery disease is to prevent stroke. Specific treatments depend on the extent of blockage in your carotid arteries. If blockage is mild to moderate, your doctor may recommend:

- Lifestyle changes to slow the progression of atherosclerosis. Recommendations may include quitting smoking, losing weight, eating healthy foods, reducing salt and exercising regularly.

- Medication to control blood pressure or lower cholesterol. Your doctor may also recommend taking a daily aspirin or other blood-thinning medication to prevent blood clots.

Your doctor may consider removing the blockage from the artery if the obstruction is significant or if you've already had a TIA or stroke. Among the possibilities are:

Carotid endarterectomy: The most frequent therapy for severe carotid artery disease is carotid endarterectomy. The surgeon accesses the damaged carotid artery and removes the plaques after creating an incision around the front of your neck. Stitches or a graft are used to mend the artery.

Carotid angioplasty and stenting: if the blockage is too difficult to access with a carotid endarterectomy, or if you have other health problems that make surgery too dangerous. You'll be given local anaesthetic, and a small balloon will be put through a catheter to the clog's location. A thin wire mesh coil (stent) is introduced to protect the artery from narrowing again after the balloon is inflated to enlarge it.