Cerebrovascular Disease (Carotid Artery Disease)
Strokes are caused by reduction in the circulation to the brain and may result in paralysis, blindness, loss of speech, or even death. A number of factors contribute to stroke risk, including hypertension, diabetes, and atherosclerotic narrowing (stenosis) of the carotid arteries in the neck. Several large clinical trials recently have reconfirmed that the surgical treatment of serious carotid artery disease with an operation called carotid endarterectomy (CEA) provides significant protection from strokes, irrespective of whether carotid stenosis already has produced temporary neurologic symptoms or is entirely symptom-free (asymptomatic). Although CEA has become one of the most common surgical procedures performed in the United States, complication rates, including the risk for a stroke caused by the operation itself, often are different from one hospital and from one surgeon to the next. Therefore, patients who have been advised to have CEA should request specific information regarding their chances for complications wherever the operation is to be done.
Many patients currently do not require preoperative arteriogram x-rays because of the accuracy of carotid ultrasound scanning in the Noninvasive Vascular Laboratory, and the average length of stay in the hospital following CEA is only 1 day.
