General Information

DEFINITION--Removal of obstruction in carotid (neck) artery due to hardening of arteries (arteriosclerosis).

BODY PARTS INVOLVED--Carotid arteries.

REASONS FOR SURGERY--Prevention of stroke and transient ischemic attacks.

SURGICAL RISK INCREASES WITH

• Adults over 60.
• Stress.
• Obesity.
• Smoking.
• Poor nutrition.
• Excess alcohol consumption.
• Recent illness such as respiratory infection.
• Atherosclerosis; coronary artery disease; or diabetes mellitus.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; beta-adrenergic blockers; or cortisone.
• Use of mind-altering drugs.

What To Expect

WHO OPERATES--General surgeon, neurosurgeon, cardiovascular surgeon, or peripheral vascular surgeon.

WHERE PERFORMED--Hospital.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies; ECG; arteriograms (See Glossary).
• After surgery: Blood studies.

ANESTHESIA--General anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• An incision is made in the neck over the obstruction.
• The obstructed area is isolated. Sometimes, a tube is used to circulate blood around the obstruction.
• A small incision is made over the obstruction, which is scraped away. The opened area is patched with a graft fashioned from a vein from another part of the body.
• If the bypass tube is temporary, it is removed.
• The skin is closed with sutures or clips, which usually can be removed in 2 weeks.

POSSIBLE COMPLICATIONS

• Excessive bleeding.
• Surgical-wound infection.
• Inadvertent injury to a branch of the nerves to the face, vocal cord or tongue.
• Stroke.
• Hematoma (blood clot).

AVERAGE HOSPITAL STAY--7 days.

PROBABLE OUTCOME--Expect complete healing without complications and restoration of good blood flow to the brain. Allow about 2 weeks for recovery from surgery.

Postoperative Care

> Move and elevate legs often while in bed to decrease the likelihood of deep--vein blood clots.

> You may use non--prescription drugs, such as acetaminophen, for minor pain.

> To help recovery and aid your well--

being, resume daily activities, including work, as soon as you are able.

• Avoid vigorous exercise for 6 weeks after surgery. Resume sexual relations when your doctor determines that healing is complete. > Resume driving 3 weeks after returning home.

DIET--Eat a well--balanced diet to promote healing.

Call Your Doctor If

Any of the following occurs: