From a presentation by Christopher Cunningham, MD McLeod Vascular Associates
A blocked carotid artery in your neck can trigger a stroke. However, McLeod Vascular Surgeon Christopher Cunningham, MD, says the fix is easy with little pain:
Here’s a summary of Dr. Cunningham’s comments:
Fixing carotid arteries is the safest and easiest cardiovascular operation. It is an operation that normally takes about an hour. There’s little or no pain.
Why so little pain? Think about two types of surgery. If a surgeon has to cut open your chest, stomach, or the muscles or bones in your legs – that’s going to hurt. You’re going to want pain medication. If you have a little cut, put a bandage on it. It doesn’t hurt much. If a doctor takes a mole off your arm, puts in a couple stitches in it, and put a bandage on the wound, it won’t hurt much.
So, even though the carotid artery is important and any surgery on it is important, the surgery only requires a small skin incision. I give every patient a pain medication prescription. But about 90% of my carotid surgery patients never fill it. They’ll tell me they didn’t need it. They took over-the-counter pain reliever.
This procedure is well tolerated by older people, because you don’t have to disturb eating, or heart and lung function to do it.
When you are put to sleep for the procedure, a couple of sensors are placed on your head. Then I’ll make an incision and expose your carotid artery.
Have you ever seen scientists looking for dinosaur skulls? They’ll use very fine tools and brushes so as not to damage the skull. It’s the same when I work on a carotid artery, because I don’t want to knock off a piece of plaque and send it to the brain, causing a stroke.
The area with the blockage is usually about one-half to one-inch long. Above and below it, the artery is perfectly healthy. Once the artery is exposed, the patient receives blood thinner to avoid forming clots. It’s clamped above and below it, where it’s healthy. I’ll open up the artery and put a temporary bypass in called a shunt.
Within one minute of operating on the artery to your brain, two important things happen. First, the blood flow to your brain is immediately better. Second, all the plaque is now out of the circuit. So, I can fix it without fear that I’m going to break off a piece and send it to your brain.
With magnifier glasses, I can see the boundary layer between the artery and the plaque. Once I’m in the artery, I literally can peel out the plaque like one plaster of Paris cast of your artery.
I’ll look back at the artery and it’ll be completely smooth with no plaque. I want to remove 100% of that plaque. Leave it perfect and close it.
When I close the incision, the shunt makes a loop so I can close the artery all the way up with string finer than hair. I take out the hose with the last couple stitches.
People will wake up after this operation within 5 or 10 minutes. We’re conversing in recovery. People are visiting. The patient is not in pain. And they go home in the morning.
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