Endarterectomy Health Article

Risks

The amount of risk depends on the hospital, the skill of the surgeon, and the severity of underlying disease. Patients who have just had an acute stroke are at greatest risk. During carotid artery surgery, blood flow is interrupted through the artery, so that paralysis and other stroke symptoms may occur. These may resolve after surgery, or may result in permanent stroke. Paralysis is usually one-sided; other stroke symptoms may include loss of half the field of vision, loss of sensation, double vision, speech problems, and personality changes. Risks of endarterectomy to treat either carotid artery or peripheral vascular disease include:

• reactions to anesthesia
• bleeding
• infection
• blood clots

Normal results

The results after successful surgery are usually striking. The newly opened artery should help to restore normal blood flow. In carotid endarterectomy, surgery should prevent the risk of brain damage and stroke. However, the buildup of fat and cholesterol usually affects all arteries, not just the one that was operated on. Affected arteries in other parts of the body may be equally clogged and potentially dangerous. Even arteries that were operated electively will likely, begin to clog up again after the surgery.

For this reason, lifestyle changes (no smoking, low fat, low cholesterol diet) are important, especially if diet and lifestyle contributed to the development of the problem in the first place.

BOOKS

"Carotid Endarterectomy." In The Surgery Book: An Illustrated Guide to 73 of the Most Common Operations, ed. Robert M. Younson, et al. New York: St. Martin's Press, 1993.

PERIODICALS

"Better Blood Flow: Surgery May Strike Down Stroke Risk." Prevention 47 (1 Feb. 1995): 50-52.

ORGANIZATIONS

National Institute of Neurological Disorders and Stroke. PO Box 5801, Bethesda, MD 20824. (800) 352-9424. <http://www.ninds.nih.gov/index.htm>.

National Institute of Neurological Disorders at the Neurology Institute. PO Box 5801, Bethesda, MD 20824.

Carol A. Turkington

KEY TERMS

Carotid arteries—The four principal arteries of the neck and head. There are two common carotid arteries, each of which divides into the two main branches (internal and external).

Diabetes mellitus—A disorder in which the pancreas doesn't produce enough (or any) insulin. As a result, the blood levels of sugar become very high. Among other things, diabetes can lead to the breakdown of small blood vessels and a high risk of atherosclerosis and high blood pressure.

Stroke—Damage to the part of the brain caused by an interruption of the blood supply. In some cases, small pieces of plaque in the carotid artery may break loose and block an artery in the brain. A narrowed carotid artery also can be the source of blood clots travelling to the brain, or the artery can become completely clogged, blocking all blood flow to the brain.