Carotid Endarterectomy Surgery Melbourne

A patient’s guide

Mr Mark Lovelock – FRACS
Vascular & Endovascular Surgeon

Carotid artery disease

Carotid artery disease is a disease in which a waxy substance called plaque (made up of fat, cholesterol, calcium, and other substances found in your blood) builds up inside the carotid arteries in your neck.

Over time, the plaque hardens and narrows your arteries limiting blood flow to the vital organs of your body and greatly increasing your chance of suffering a stroke.

What is Carotid Endarterectomy Surgery

Carotid endarterectomy is a surgical procedure used to help correct carotid artery disease. The surgery aims to open and clean the plaque that is partially blocking the carotid arteries (found in your neck) to help restore blood flow and prevent stroke.

What happens during Carotid Endarterectomy Surgery

Before the Operation – Mr Mark E Lovelock

You will be admitted to hospital the night before surgery.  Your Anaesthetist and Mr. Lovelock will visit you to discuss the procedure and address questions you may have regarding the surgery.

No blood transfusion is required for this procedure however, preoperative blood testing will be undertaken to check on your blood haemoglobin level and chemistry. A electrocardiogram (ECG – measures your hearts rhythm and activity) is done before surgery to check on your heart function.

The operation

The operation lasts approximately 1 – 1½ hours and proceeds as follows:

  • You will be placed under general anesthetic
  • An incision (cut) will be made into your neck to allow access to your carotid artery.
  • Your carotid artery is opened and Mr Lovelock removes the plaque inside the artery.
  • After the plaque is extracted, the artery is closed (stitched).
  • Your heart activity will be monitored closely during surgery.
  • After the procedure, Mr Lovelock may do a test to confirm that the artery has been opened.

At completion of the operation you will have a bandage around your neck and there should be minimal discomfort as local anaesthetic is used in the wound to reduce pain.

After the Operation

The neck wound following surgery does not usually require strong drug use. Panadeine or Panadol is usually adequate for pain control.

24 hours after surgery – You should be able to get out of bed and be able eat and drink normally.

2 to 4 days after surgery – Most patients are discharged from the hospital during this peroid.

Scar care post surgery

Fading of the neck scar may take between six weeks and six months. We recommend massaging the scar site two weeks after your procedure and continue for six weeks. Face cream can be used as a lubricant when massaging the scar. Approximately 20 strokes should be administered to the area of the scar at night. You will notice some numbness in the area of the scar, this is a normal.

Post surgery follow up

Mr. Lovelock will follow your recovery. Scans may need to be taken every 12 months. Post-operative ultrasound scans will be requested to assess healing progress of the artery.

Any untoward pain in relation to your operation or recurrence of your previous symptoms, should be reported to Mr. Lovelock immediately. Other general medical problems should be referred direct to your GP.

Potential complications

Stroke – Although the procedure is designed to prevent stroke in the long term there is a small chance of a stroke occurring either during the operation or in the immediate period after your operation (48 hours). The chance of this happening is usually less than 1%.

Heart Attack – The second most major risk associated with the surgery is one of heart attack and this risk is approximately 1 – 1.5%.

Post surgery exercise and effectiveness

Exercise – After your discharge from hospital you may resume most normal activities but heavy exercise should be avoided for approximately seven days after your operation. You may drive a motor vehicle following discharge from hospital unless you have any untoward symptoms.

Effectiveness – Recurrence of the problem of blockage occurs in less than 2% of patients. Long term reduction in stroke risk has been documented to be approximately. 0.2% per annum for this operation.

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