How is carotid endarterectomy performed?
The operation can be performed under general or regional anesthesia. With general anesthesia, you are completely asleep, and placed on the ventilator. With regional anesthesia (a local anesthesia block of the neck), you are awake. A skin incision is made in the neck, along the course of the carotid artery, and control is obtained of the carotid arteries. You are given heparin, a blood thinner, and the arteries are clamped, opened, and plaque is removed. The artery is then usually reconstructed with a patch, and blood flow is reestablished to the brain, and the wound is closed. One can expect to be discharged the next day. If performed under regional anesthesia, the surgeon can continually assess your neurologic function. When performed under general anesthesia, a shunt may be placed in the artery to allow continual blood flow to the brain while the plaque is removed. Alternatively, a shunt does not have to be used if various adjunctive measures assess adequate blood flow to the brain,
