At North Orlando Surgical Group, we are proud to have established a unique surgical practice characterized by superior skills and extraordinary services both to the patient we care for as well as their referring physicians. We are recognized in Central Florida for our ability to perform complex procedures in the least invasive way. Our attentive staff is focused on providing the highest level of personal services and are committed to making every patient’s surgical experience as comfortable and convenient as it can be.
Carotid stenosis is a condition affecting the internal carotid arteries in the neck which supply blood to the brain. Stenosis is usually found by ultrasound and can be an indication that you are at risk for a stroke. About 800,000 patients suffer from strokes each year. They can be devastating to the patient as well as their family. A stroke can impair your ability to communicate, move, care for yourself and may even lead to death. Annual carotid ultrasound is an excellent tool to identify who may be at risk for a stroke, and thereby treat the patient to avoid this event from occurring. Several factors can contribute to the development of carotid stenosis:
• High blood pressure
• High cholesterol
• Diabetes
• Aging
• Smoking cigarettes and the use of other tobacco/nicotine products
Usually there are no noticeable symptoms from this condition until a major event like a stroke occurs. Occasionally a person will have symptoms of a mini-stroke or TIA prior to a major event. These can include numbness or weakness effecting one side of the body and not the other, temporary blurring of vision in one eye and not the other, or difficulty speaking or understanding speech. If you are found on ultrasound to have a narrowing in one of your carotid arteries you will most likely undergo a CT angiogram to evaluate the degree of narrowing further. If this study confirms a narrowing, especially if you are experiencing symptoms of a mini stroke. You should be sent to a surgeon to discuss surgery. For women with greater than 70% stenosis without symptoms surgery should be considered. For men with greater than 60% stenosis without symptoms surgery should be considered. But if both men and women are experiencing symptoms with 50% stenosis or greater then surgery should be discussed with your surgeon.
At North Orlando Surgical Group, Carotid endarterectomy is done while the patient is awake. In this way the doctor can evaluate the patient throughout the operation for any signs of stroke. This is the only definitive method of detecting and avoiding a stroke during surgery. Before the procedure has begun you will be given numbing medication to completely numb the side of your neck. You will also be given sedation to relax you and the operating table will be put in a beach chair position. This will allow you to remain comfortable during the procedure. Once the patient has been made comfortable the surgeon will make an incision in the neck. The artery will be exposed and a clamp placed above and below this incision to avoid bleeding. The patient’s mental status will evaluated to by asking the patient a series of questions. When it is evident that they are alert and not suffering any ill effects of the artery being clamped, the surgeon will then proceed to clear out the area of blockage. A patch will be placed over the artery to make it larger than it was before in an effort to keep the artery from narrowing again in the future. The incision will then be closed. You can expect to spend one night in the hospital and be discharged the following day. You will be asked to follow up in the office about four weeks after surgery for a quick wound check. We will continue to monitor your carotids, at least annually with an ultrasound following surgery.
Carotid endarterectomy can greatly reduce your risk for having a stroke related to carotid stenosis. However, not all surgeons have the experience and skill to see you safely to the recovery room! If you have been advised that you have narrowing in your carotid arteries be sure you are seeing a surgeon with the skills to get you both on, AND off the operating table safely. Call our office today to make an appointment to discuss your care with our specialist!