What is surgical repair for an extracranial carotid artery aneurysm?
The mainstay of treatment of extracranial carotid artery aneurysms is surgical repair. The surgical repair entails the resection of that portion of the carotid artery that is involved with the aneurysm, followed by a bypass.
Why is this procedure performed? Why do I need this procedure?
Symptoms for carotid artery aneurysms may include transient ischemic attacks (TIAs) or stroke. In addition, carotid artery aneurysms may form clots that block blood flow to your brain. If this occurs, or in order to prevent this from occurring, treatment may be warranted.
Other symptoms can occur secondary to pressure of the aneurysm on surrounding structures such as veins and nerves. These symptoms can vary, depending upon what is compressed, but may include facial swelling, hoarseness or difficulty swallowing. Rarely, carotid artery aneurysms can rupture, or burst, which is a life-threatening problem.
Each patient is evaluated, and treatment will be individualized for the patient’s circumstances.
Where is the procedure performed and who performs this procedure?
This procedure is performed in the hospital surgical suite by a vascular surgeon.
What are the risks and potential complications of the procedure?
Your doctor will discuss the specific risks and potential benefits of the recommended procedure with you.
Surgical repair usually has no complications, but there may be a risk of injury to the adjacent nerves that affect your tongue and voice. The most concerning risk is risk of stroke, but this is very rare. Your vascular surgeon will discuss the important risks and benefits with you.
Special precautions are taken to decrease these risks, and there may be other possible risks. When you meet with your doctor, please ask questions to make sure you understand the risks of the procedure and why the procedure is recommended.
How do I prepare for the procedure?
A few days before the procedure, pre-procedure tests may be performed to ensure that it is safe to perform the surgery. You may need to discontinue certain medications before the procedure. Your health care team will provide specific instructions to help you prepare for the procedure.
What happens during the procedure?
The surgical repair will be performed under general anesthesia. The surgeon will expose the carotid artery aneurysm, and the normal carotid artery above and below the aneurysm, through an incision in the neck. The blood flow in the artery is stopped with special clamps, and the aneurysm is excised. Blood flow may temporarily be provided to the brain through a small tube placed in the carotid artery called a shunt. A bypass is then performed from the normal artery below the aneurysm to the normal artery above the aneurysm. The bypass may be performed with a variety of different conduits including a piece of vein taken from the leg, a piece of artery taken from another spot in your body, or a prosthetic graft made out of Gortex or polyester. The type of bypass material used will be determined by your surgeon.
How long does the procedure last?
The procedure itself generally takes two to three hours, but the preparation and recovery time add several hours. The surgery may require a minimum hospital seven to 10 days.
What happens after the procedure?
Most patients require routine admission to an intensive care unit for close monitoring for about one to two days after the surgery. Once the patient is transferred to the nursing unit, the hospital stay is about three to seven more days. Most patients will receive physical therapy during the recovery period.
Your doctor will provide specific guidelines for your recovery.
Are there any side effects of the treatment?
As with any surgical procedure, you will feel somewhat tired for a few weeks. There is minimal pain associated with the incision. You may temporarily have a hoarse voice or some difficulty moving your tongue, but these are typically limited.
Results of the procedure
Surgical repair of carotid artery aneurysms usually provides good relief of symptoms. Your physicians will discuss the results of your procedure with you.
How do I find out if I am a candidate for this procedure?
To find out if you are a candidate for this procedure, please call the Vascular Surgery Department at 216.444.4508 or 800.223.2273 ext. 4-4508.