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Sunday, December 21, 2014
how to cut down on the probability of stroke from a clogged carotid artery before surgery and during surgery?
I am not a surgeon, and do not perform such surgeries. Here are a few general points:
1.) It is important to make sure that you truly need such a surgery before proceeding. If you have had a stroke or TIA and the carotid artery is more than 70% blocked, then all would agree that a carotid endarterectomy (CEA) is beneficial to prevent future strokes. For any other situation, it is a little more controversial. It might be helpful to get a second opinion, and you might even consider getting one from a neurologist instead of a surgeon since the neurologist will have no vested interest in doing the procedure (a surgeon will have at least the potential for bias towards surgery since surgical procedures lead to financial compensation for them).
2.) Some factors that have been proven to be associated with the "safest" CEA are a surgeon who does the procedure frequently, and a hospital that does a high volume of the surgery. One of the possible complications from the surgery is a stroke. Some research suggests that neurosurgeons have fewer strokes than other types of surgeons, but this is highly controversial. The most important thing is the expertise and experience of the surgeon and surgical team.
3.) The use of medications before and after the surgery is important--your surgeon will direct you, but it is important for you to be diligent in following the instructions to prevent complications.
I hope this helps.
Brett Kissela, MD
Assistant Professor of Neurology
Director, Neurology Residency Program
College of Medicine
University of Cincinnati