تعريف
The carotid artery carries blood through the neck to the brain. Blockage of this artery can lead to brain damage called a stroke.
A carotid artery endarterectomy is a surgery to remove the deposits from this artery. Deposits in arteries result in plaque. This can slow and even stop blood from flowing through the artery.
أسباب هذا الإجراء
This procedure helps to restore proper blood flow to the brain. This will help to prevent strokes and transient ischemic attacks (TIAs). TIAs are considered a warning sign of a stroke.
المضاعفات المحتملة
If you are planning to have an endarterectomy, your سيقوم الطبيب بمراجعة القائمة من المضاعفات المحتملة، والتي قد تشمل:
- نزيف
- العدوى
- Damage to the carotid artery
- High blood pressure or low blood pressure
- سكتة دماغية
- Nerve injury in the neck
تشمل العوامل التي قد تزيد من خطر حدوث مضاعفات ما يلي:
- التدخين
- The degree of blockage in your carotid artery
- Blockage of the carotid arteries on both sides of your neck
- مرض السكري
ما يمكن توقعه
قبل الإجراء
قد يقوم طبيبك بما يلي:
- اختبارات الدم والبول
- Electrocardiogram (ECG, EKG) —a test that records the heart’s activity by measuring electrical currents through the heart muscle
- Arteriogram—a type of x-ray in which a contrast material or dye is injected into the arteries to make them more visible
- Ultrasound —a test that uses sound waves to examine the carotid arteries
- Magnetic resonance angiography (MRA) scan —a test that uses magnetic waves, along with a contrast agent, to make pictures of arteries
التحدث مع طبيبك عن الأدوية الخاصة بك. قد يطلب منك التوقف عن تناول بعض الأدوية تصل إلى أسبوع واحد قبل العملية مثل:
- الأدوية المضادة للالتهابات
- مميعات الدم
في الليلة السابقة، تناول وجبة خفيفة. لا تأكل أو تشرب أي شيء بعد منتصف الليل.
التخدير
You and your doctor will discuss using either:
- General anesthesia —You will be asleep.
- Local anesthesia—The area will be numbed.
وصف الإجراء
You will lie flat on a table. A roll will be placed under your shoulder. Your head will be turned to the side. A cut in the skin will be made along the side of the neck. The cut will run from just behind the ear to a point above the breastbone. Clamps will be placed above and below the plaque on the carotid artery. In some cases, a temporary bypass tube will be used to maintain blood flow around the area that is being operated on.
The artery will be opened and cleaned of plaque. The artery will then be sewn back together. The clamps, and bypass tube, if used, will then be removed. A section of the carotid artery may need to be removed. In this case, an artificial graft or a segment of vein will be sewn in to replace it. The neck incision will be closed with stitches.
مباشرة بعد الإجراء
An arteriogram may be done to ensure that there are no complications, such as blood clots or narrowing. You may be given medicine to help prevent blood clotting.
كم من الوقت سيستغرق ؟
2-4 hours
كم هو مؤلم ؟
Anesthesia will prevent pain during the procedure. You will be given medicine to help manage any pain.
متوسط الإقامة في المستشفى
The usual length of stay is 1-3 days. Your doctor may choose to keep you longer if complications occur.
رعاية ما بعد العملية
في البيت
The average recovery time is two weeks. When you return home, do the following to help ensure a smooth recovery:
- Keep your neck straight. Keep the head of your bed elevated during recovery.
- Take medicines as prescribed by your doctor. Anticoagulants will help to prevent blood clots. Prescription and nonprescription pain relievers will help with any discomfort.
- Resume your daily activities as soon as you are able.
- Do not drive for three weeks after surgery or until your doctor says it is okay.
- Avoid vigorous exercise for six weeks after surgery.
- Make dietary changes to help prevent a return of plaque build-up. Eat a diet low in saturated fat. Make sure your diet is high in fruits, vegetables, grains, and fish. You may want to see a registered dietitian for help in making these changes.
- اسأل طبيبك حول, عندما هي آمنة للاستحمام, السباحة, أو نقع في الماء.
- تأكد من اتباع تعليمات طبيبك.
استدعاء الطبيب
بعد مغادرة المستشفى، اتصل بطبيبك في حالة حدوث أي مما يلي:
- علامات الإصابة, بما في ذلك حمى وقشعريرة
- احمرار، تورم، زيادة الألم، نزيف مفرط، أو إفرازات في موقع الشق
- الغثيان و / أو القيء الذي لا يمكنك السيطرة عليه بالأدوية التي أعطيت لك بعد الجراحة ، أو التي تستمر لأكثر من يومين بعد الخروج من المستشفى
- ألم لا يمكنك السيطرة عليه بالأدوية التي أعطيت لك
- Severe headaches, swelling in your neck, or other new symptoms
- السعال وضيق التنفس وألم الصدر
- فقدان الذاكرة
- Drooping facial muscles
- Difficulty with speech, vision, or with moving
- ضعف
- Arm pain
- Extreme sweatiness
- Lightheadedness or fainting
في حالة الطوارئ ، اتصل على المساعدة الطبية على الفور.