Operation on carotids Sleepy arteries are the vessels through which the organs of the neck and head are supplied. These arteries move away from the aorta in the chest, and deep inside the muscles pass through the neck and skull into the human brain. In atherosclerosis carotid arteries are affected in the last turn, when the rest of the vessels already affected, but the likelihood of atherosclerotic carotid arteries increased in the elderly, for example, 10% of people aged between 80 and 89 there are significant narrowing of the carotid arteries, which canLead to a violation of cerebral circulation and cause strokes. Also, atherosclerotic changes in the carotid arteries cause thrombophlebitis and blockage of small arteries and veins.

In almost all cases of detecting changes in the carotid artery, doctors recommend operative interventions. Operation on carotid arteries is almost the only effective method of treating the disease, conservative treatment is prescribed only in cases of severe contraindications to the operation.

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The basis for indications for surgical treatment are anatomical changes in the carotid arteries. Operation

is shown carotid artery stenosis or occlusion sigmentarnoy if:

  • narrows the artery stenosis permeability to 30% or more;
  • the lumen of the vessel is uneven;
  • history of the patient there are cuts, visual disturbances, aphosia, frequent loss of consciousness;
  • is clearly a progressive symptom of the disease;
  • disorders of the carotid artery from the opposite side;
  • occlusion of subclavian or head artery.

Absolute indications for surgery are aneurysm or carotid artery damage.

Contraindications

operation on arteries has a number of contraindications, if progressive phenomenon led to irreversible phenomena if there have been cases of severe impairment of consciousness and coma, there is an acute stage of ischemic disease of the brain, brain bleeding, complete blockage of the internal carotid artery entering the baseSkull.

The most promising surgery in those patients with the onset of symptoms of cerebral ischemia and with minor neurologic changes.

Often, the operation on the carotid internal arteries is purely preventive in nature, it is used with minor symptoms of the disease in order to avoid the development of serious consequences.

Carrying out the operation.

essence surgery on the carotid arteries Zach is to remove plaque and restore the vessel lumen. The choice of this or that method of conducting the operation depends on the severity of the carotid artery and the accompanying pathology. The question of choosing a surgical method can only be taken by the doctor himself.

In modern surgery, there are two main methods for surgical treatment of atherosclerotic lesions of the carotid artery: endarterectomy and balloon angioplasty and stenting. When

endarterektomicheskom method of surgical exposure to the patient is general or local anesthesia, thus it made a small incision through which the extracted atherosclerotic plaque.

access and allocation of the carotid artery of difficulty for an experienced surgeon can not imagine some of the difficulties is interference in the area of ​​the bifurcation of the carotid artery or in a sleepy area of ​​a triangle( approximate to the carotid fork).The patient is operated in a sitting position, placing a roller under his neck and turning his head slightly. Along the lower jaw a cut about 10 cm is made, then they approach the vagina of the vessel and with the help of forceps and clamps the veins and nerves are removed and the carotid artery is removed.

Some surgical interventions use a shunt, which is an elastic synthetic tube that is inserted into the internal carotid artery, providing an unobstructed blood supply to the brain. The narrowing of the lumen of the vessel by less than 80%, the inflection of the vessel caused by a constriction or an aneurysm, bilateral changes in the carotid arteries are absolute indications for the imposition of a shunt.

Angioplasty and stenting

The procedure for angioplasty and stenting is a more modern less invasive operation that is performed under local anesthesia. Through a puncture in the inguinal region, a catheter is inserted into the femoral artery to the site of the damaged carotid artery, through which the material for angioplasty and stenting is delivered. With the help of X-rays we get an image on the monitor, then under the supervision of a doctor, is injected with a balloon that is blown off and swollen, thereby realizing the necessary clearance in the vessel.

In addition to the two main types of operations on the carotid arteries, there are other methods of operation, carotid prosthetics, and carotid endarterectomy. Such a variety of methods is due to various types of carotid artery reconstruction and ways to restore lumen. The technique of performing access to the carotid arteries in all cases, except stenting, is the same.

Prosthesis is performed in cases where the patient has an extensive lesion of the internal wall of the carotid artery, and the likelihood of disruption of the integrity of the artery.

The risk of a lethal outcome exists for all types of surgical intervention, but it does not exceed a few tenths of a percent for operations on carotid arteries, and the incidence of neurologic complications is no more than 1-2% of the total number of operations.

Mechanical damage to the artery.

A special group of risk includes surgery for injuries from the artery. Mechanical injuries of the carotid artery represent the greatest danger - heavy bleeding, extensive blood loss and impaired blood supply to the brain due to a puncture of the artery in a very short time leads to death. In this case, surgical intervention is carried out according to the scheme described above, the operation in this case involves difficulties and does not always lead to a positive outcome.