Carotid Artery Disease Treatments
Carotid artery stenosis is treated surgically by two main methods. Open surgery (Carotid Endarterectomy) has been perfected over decades, and is a reliable, and well proven treatment for carotid artery stenosis. It involves an incision on the neck, removal of the plaque in the carotid artery, and placement of a patch to keep the artery wide open and prevent it from narrowing again. Patients are usually in the hospital for one day after the procedure.
The other method of treating carotid artery stenosis includes placement of stent within the artery, usually delivered from an artery in the groin. This procedure involves no incisions, and is a minimally invasive alternative to open surgery. Each approach (endovascular carotid stenting vs open carotid endarterectomy) has its advantages in certain circumstances.
Those with a high degree of carotid artery stenosis may benefit from intervention with either open surgery (carotid endarterectomy) or stenting. Open surgery is the gold standard, and is currently recommended for most patients as first-line treatment. However, some patients may benefit more from stenting, such as those with previous neck dissection, a history of neck radiation, and other factors that may make carotid endarterectomy more risky.
Patients with a high degree of carotid artery stenosis, or those with a history of symptoms, should consult with a vascular surgeon to determine whether open surgery or stenting or simple observation with optimal medical management is appropriate. The surgeons at San Francisco Vein and Vascular Institute have established expertise in the utilization of both modalities and we tailor our approach according to the needs of our patients as opposed to the needs of the physician.
Surgery is what type of commitment?
Surgery is done as an inpatient. You are in the hospital for 1-2 days. You must check in 2 (two) hours before your surgery time. The procedure takes about 2 hours.
You will need someone to drive you home when you are discharged, usually the next day.
You should plan on being off from work/activity for 2 weeks.
You cannot fly for 1 month after your procedure. You will want to avoid sun exposure to the incision on your neck for 6 months.
What happens at the hospital?
You will meet with an anesthesiologist at the hospital to help you decide on a type of anesthesia (general, local cervical block, etc).
You will be given a prescription for pain medication before you leave the hospital.
Your staples will be removed before you leave the hospital and replaced by steri-strips (strong band aids).
What should I expect after I go home?
Your steri-strips will fall off when they are ready (about one (1) week). You can shower and wash regularly.
You will be unable to drive for 10 days, or until the stiffness in your neck goes away.
It is normal to have neck swelling and/or bruising.
You may have a hoarse voice and some numb areas in your neck. This improves with time.
You will be seen in our office for a follow-up in 10-14 days. Call to schedule your appointment once you are home.