When is this procedure indicated?
It is indicated when the percentage of internal carotid artery stenosis is 70% or greater or if the patient had symptoms suggestive of a cerebral ischemic event (dysastria, amaurosis, steno/sensory deficits in the upper extremities), although the percentage of stenosis was less than 70%.
How is it performed?
The procedure is performed through an incision on the anterior margin of the sternocleidomastoid muscle and progressive isolation of the internal, common and external carotid artery. Subsequently, a cut is made on the artery to allow exposure of the atherosclerotic plaque and its removal. The patient is awake as plexus anesthesia (plexus-cervical) is performed, which allows surgeons to closely monitor if the patient has ischemic events during the procedure. If so, the surgery will continue with the use of a shunt to allow adequate cerebral flow.
The length of stay is usually 4 days.
Stroke, TIA, latero-cervical hematoma with tracheal and/or esophageal detour.
Infection, wound dehiscence, restenosis in endoarterectomy outcomes.