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Carotid artery surgery Description:
There are four carotid arteries, two on each side of the neck: right and left internal carotid arteries, and right and left external carotid arteries. The carotid arteries deliver oxygen-rich blood from the heart to the head and brain. When the carotid arteries become blocked by fat and cholesterol build-up, the patient experiences brain symptoms, such as stroke . By removing the fat and cholesterol build-up inside the artery, adequate blood flow is restored.
While the patient is deep asleep and pain-free (using general anesthesia), an incision is made in the neck, over the blocked carotid artery. A tube is inserted above and below the blockage to re-direct the blood flow while the surgeon opens the carotid artery and removes the fat and cholesterol build-up. The artery is stitched (sutured) closed, the tube is removed, and the incision is closed.
Indications:
Symptoms of carotid artery blockage, such as: - weakness of the arm, leg, or face on one side of the body
- loss of ability to move ( paralysis ) the arm, leg, or face on one side of the body
- numbness , tingling , or noticeable change in the sensation of the arm, leg, or face on one side of the body
- difficulty swallowing
- loss of all or part of vision ( blindness ) in one eye
- slurring of speech or inability to speak
- dizziness ( vertigo )
- confusion , fainting , or coma
- stroke with complete recovery
Many symptoms may be permanent.
X-ray studies using special dyes ( carotid angiogram ) can show the degree of blockage of the carotid arteries.
What to Expect After:
Carotid artery surgery usually helps prevent further brain damage and reduces the risk of stroke . However, the build-up of fat and cholesterol (plaque) usually affects all the arteries and tends to build-up again after removal.
Convalescence:
Two first days are spent flat in bed. The patient should avoid bending the neck sharply in any direction.
Risks:
Risks for any anesthesia are: Risks for any surgery are: Additional risks of carotid surgery include:
Cost:
The costs of any surgery varies significantly between surgeons, medical facilities, and regions of the country. Patients who are younger, sicker, or need more extensive surgery will require more intensive and expensive treatment.
Surgery charges can be separated into five parts:
1. Surgeon's fee: approximately $1,800 to $2,500.
2. Anesthesiologist's fee: averages $350 to $400 per hour
3. Hospital charges: basic rate averages $1,500 to $1,800 per day (more for the intensive care unit (ICU) or private rooms)
4. Medication charges: $200 to $400
5. Additional charges: assisting surgeon, treatment of complications, diagnostic procedures (such as blood or Xray exams), medical supplies, or equipment use.
Insurance coverage for surgery expenses depends on many factors and should be explored for each individual instance.
A carotid arteriogram is an X-ray study designed to determine if there is narrowing or other abnormality in the carotid artery, a main artery to the brain. This is an angiogram of the left common carotid artery (both front-to-back and side views) showing a severe narrowing (stenosis) of the internal carotid artery just beyond the division of the common carotid artery into the internal and external branches .
This is an angiogram of the right carotid artery showing a severe narrowing (stenosis) of the internal carotid artery just past the carotid fork. There is enlargement of the vein or ulceration in the area after the stenosis in this close-up film. Note the narrowed segment toward the bottom of the picture.
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