Carotid endarterectomy (EDA) or carotid thromboendarterectomy (TEA), applications and uses

Carotid Thromboendarterectomy (TEA) is the surgical technique consisting of, once a cutaneous incision has been made at the level of the internal border of the sternocleidosmastoid muscle of the neck, the carotid bifurcation composed of the primitive or common carotid artery which is divided into internal and external carotid is dissected or controlled. After heparinizing -preventing blood clotting by means of heparin- the patient and closing proximally and distally these arteries with special forceps called clamps, the bifurcation is opened (arteriotomy) and the origin of the external carotid artery and the lesion of the internal carotid artery is “cleaned” (thrombectomy) by removing the cholesterol and/or calcium plaque that occupies the lumen of the arteries (endarterectomy). Once this is done, it is closed, either directly or using a patch that can be artificial or from a vein in the patient’s body. This procedure in our environment is performed under local anesthesia, and after 12 hours in the ICU, the patient is discharged from the hospital the following day.

When is it necessary for a patient to undergo Endarterectomy or Thromboendarterectomy?

Patients who can benefit from this intervention are those who have a stenosis (closure) of the lumen of the internal carotid artery greater than three quarters, whether or not they have presented any type of neurological symptoms derived from this stenosis. Logically, it will be necessary to make a preoperative assessment of the possible benefits and possible complications that may arise.

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When is the use of Endarterectomy or Thromboendarterectomy not recommended?

Carotid revascularization – to provide irrigation to the part of the brain dependent on this artery – can be performed by means of three techniques: open or traditional open surgery, endovascular techniques, angioplasties (PTA) and/or stents and by-passes or bridges. If we talk about EDA and its contraindications, we could refer to two situations; one clinical, which would imply a high surgical risk, patients with important cardiological or general pathologies and the other, technical; with the presence of very high lesions, hostile necks, very calcified arteries, etc. In these cases, endovascular or medical treatment could be chosen.

How long is the estimated recovery time after endarterectomy or thromboendarterectomy?

As mentioned above, if there is no complication, the patient is discharged from the hospital and can lead a completely normal life.

Would a person who has undergone carotid endarterectomy have to change his or her lifestyle after recovering from surgery?

Not at all, since the intervention was performed precisely so that your brain receives more blood and you can lead a completely normal life.

For more information, consult with a specialist in Angiology and Vascular Surgery