The arteries are blood vessels that carry oxygen-rich blood throughout the body. In normal, healthy arteries, the inside of the artery is open and the lining is smooth. This allows blood to flow freely from the heart to the brain.
Damage to the artery walls can occur with certain health factors such as smoking, high blood pressure, and diabetes. This damage causes the lining of the artery to become rough, which is known as arthrosclerosis. This allows cholesterol and other elements in the blood to stick to the artery wall, forming plaque. As plaque continues to build up, a narrowing of the artery occurs. Blood clots can also form on the plaque.
Having plaque in the arteries is dangerous because the plaque can rupture, allowing small pieces of plaque and blood clots to travel freely in the bloodstream. These small pieces of plaque and blood clots can become lodged in smaller blood vessels, cutting off blood flow to that area. Stopping blood flow to vital organs can be very dangerous or even deadly: strokes are caused by cutting off blood flow to the brain and heart attacks are caused by cutting off blood flow to the heart. Blood flow to other tissues can be cut off as well.
Different testing methods such as ultrasound are used to determine the location and severity of the blockage. An angiogram is another diagnostic test that it sometimes used to get a more detailed picture of the location and size of the blockage. An angiogram is done by injecting contrast fluid through into the blocked artery to take x-ray images of the blockage. If Dr. Robbins determines that the blockage is severe enough, he may recommend endarterectomy as a form of treatment. An endarterectomy is the surgical removal of plaque from an artery that has become blocked or narrowed.
What to Expect
The details of endarterectomy depend on the location of the blockage. Generally, Dr. Robbins makes an incision in the skin over the site of the narrowed or blocked artery. Once the blockage is located, he next makes an incision in the artery itself. Sometimes a shunt is used to maintain blood flow. A shunt is a tube that is inserted above and below the blockage that allows blood to keep flowing rather than being cut off while Dr. Robbins works to remove the plaque. Dr. Robbins then works to loosen and remove the plaque or clot with a special tool. Once he is satisfied that the artery is clean, Dr. Robbins may widen the artery with a graft, a manmade tube that is designed to keep the artery opened. Dr. Robbins will then close all incisions made with sutures (stitches).
Preparing for Your Procedure
Our office will tell you how to prepare for your procedure. This includes special instructions about medications. Be sure to follow the instructions we give you, or your surgery may have to be canceled.
A Week Before
- Tell us about any allergies you have.
- Tell us about any medications you take, including prescriptions, over-the-counter medications, supplements, and herbs.
- Make medication changes as we direct you. This can involve stopping certain medications you normally take or starting certain medications before surgery.
The Day Before
- Don’t drink or eat after midnight the night before you surgery. Do not smoke, chew tobacco, or chew gum after midnight. If you were instructed to continue any medications, take them with a sip of water only.
- Arrange a ride home for when your recovery is finished.
- Follow any special instructions we give you.
The Day of the Procedure
- Arrive on time to the hospital.
- Bring all medications you take with you to the hospital.
- Hospital staff will prepare you for the procedure.
How long you stay in the hospital depends on the location of your endarterectomy. Dr. Robbins will closely monitor your progress immediately after surgery, and you will need to schedule a follow up appointment with our office in the next 2 weeks. Here are some guidelines to follow during your recovery:
- Keep the incision or puncture site clean and dry.
- Take medications as prescribed.
- Do not drive until cleared to do so.
- Avoid lifting objects more than 10 pounds for a week or otherwise instructed.
When to call VascularTyler
Call our office if you experience any of the following:
- Problems at the incision site such as swelling, increasing pain, redness, or warmth
- Mental confusion or headaches
- Persistent vomiting