Preventing Strokes In Those Who Are At Risk - Carotid Artery Surgery Procedure

Main Category: Stroke
Also Included In: Cardiovascular / Cardiology
Article Date: 22 Oct 2008 - 5:00 PDT

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Patients at Pilgrim Hospital, Boston, England, are benefiting from a procedure introduced recently which helps to prevent strokes in those who may be at risk.

Mr Jayarama Mohan has carried out more than 60 carotid artery surgery procedures - and has seen positive results in all cases.

Mr Mohan said patients are referred to him by other physicians, often when they have had the symptoms of a minor stroke or are at risk of future strokes. "The symptoms these patients may have experienced include numbness, weakness on one half of the body or an arm or a leg, speech problems and a loss of vision in one eye. Even if these symptoms only last for a short period of time and then recede they could be a signal of a small stroke," said Mr Mohan.

"The surgery we do might be able to help these patients by preventing the onset of a major stroke."

The symptoms of small strokes are often caused by the narrowing of the carotid artery, the artery which supplies blood to the brain. This artery can be narrowed with cholesterol and blood clot, and as this is a spongy substance, pieces can break off. When they do break off and get into the blood stream, they can get into the brain, become lodged there and cause a part of the brain to die- causing a stroke.

If someone is having small strokes, that is often because they have this happening inside their artery. Carotid artery surgery removes this narrowing, reducing the risk of further small and large strokes. A big stroke could be devastating resulting in the patient dying or being permanently bed-bound or profoundly disabled.

"The procedure involves going into the carotid artery and removing the material that is causing the narrowing," said Mr Mohan.

"In general, this procedure carries with it great benefits, as it can often prevent patients from having strokes. It is usually used on patients who have had small strokes and are at risk of having a large one, but can also be used on those who had a moderate stroke to prevent a further one happening. "The procedure does also carry risks, but for all of the patients we have carried this surgery out on so far it has been a great success," he said.

"No one who I have carried this procedure out on has had a further stroke within one month- which is the metric used to measure the success of the procedure. Most of my patients have recovered very well and are extremely grateful, as it has reduced their risk of stroke and enables them to lead a more normal life."

Patient Thomas Whiteley from Skegness had the surgery in April this year and said he is extremely grateful to the doctors who carried out the procedure. "One night I was watching TV and I went blind in my right eye, then it happened again a few hours later. I later found out that this was the symptom of me having had two small strokes," he said.

"The doctors at Pilgrim decided that I would be an ideal candidate for carotid artery surgery and I'm so glad they did. It has really put my mind at ease that I am now much less likely to suffer from a stroke again.

"They cared for me really well and everything went fine. This has allowed me to carry on with my life as normal and for that I'm extremely grateful."

Marilyn Spiking from Boston also had carotid artery surgery at Pilgrim in March this year and said it was "excellent."

"I had suffered from two minor strokes and so my doctors talked over my case and decided this surgery would be the best thing for me," he said.

"And I'm sure it has been. The surgery took about four hours and it was rather strange because you are awake when they are doing it. But my scar has healed very well and I feel much better now, I'm so grateful."

The carrying out of carotid artery surgery requires input from many experts for different aspects - including expert assessment by Consultant Physician and Pilgrim Stroke unit Lead Dr David Mangion,, expert local anaesthetic service by Dr Wasim Butt and close post-operative monitoring in the Intensive Care Unit for a few hours.

United Lincolnshire Hospitals NHS Trust

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