Carotid endarterectomy procedure “is a surgical procedure to open or clean the carotid artery with the goal of stroke prevention.”4 This procedure is performed on patients who have a moderate (50-79%) blockage and are experiencing symptoms coinciding with a stroke, mini-stroke, or TIA. Also, patients presenting with a severe (more than 80%) blockage whether they have symptoms or not. Carotid artery stenting has been compared to the carotid endarterectomy and for some surgeons it’s considered a good alternative. In a study published in 2016, it was found that stroke/death rates were significantly higher in patients undergoing a carotid artery stent when compared to a carotid endoarterectomy.5 This suggests the carotid endarterectomy is the best option for patients presenting with blockages. Due to this patient’s symptoms we can infer he may have had a mini-stroke or TIA. The patient experienced a temporary episode of stroke like symptoms which commonly occurs when a clot causes a blockage but is then dislodged or …show more content…
Among the pros the patient will have a significantly lower chance of having a first-time stroke. Also following the procedure, the arteries remain clear for an extended period depending on the patient’s lifestyle and post-operative care. Some cons of the procedure are complications including postoperative stroke, heart attack, breathing problems, and nerve damage of the tongue or vocal cords. Another con is the possibility for restenosis or plaque redeveloping in the artery. Normally this is caused by the patient’s postoperative lifestyle. It is encouraged by doctors for patients to exercise regularly, eat healthy, and ensure their BP is controlled to prevent the reformation of plaque.8 As long as the patient understands the risks and benefits associated with the procedure they can make a clinical decision with the help of their
In more severe cases, a surgical procedure known as endarterectomy is suggested. An edarterectomy is an operation used to widen the carotid artery. This is usually an option if it has been determined that the internal carotid artery is narrowed by more than 70% and if the person in question has been displaying stroke-like symptoms during the previous six to eight months. This surgery is usually used to prevent the future risk of a stroke. This procedure has been shown to prevent blockage of the internal carotid artery over time and usually involves removing fatty deposits and clots in this important artery.
The purpose for the stent was to hold the coronary artery open to allow the blood to flow more freely.
Ischemic Stroke is caused due to a blood clot in an area of the brain, leading to loss of neural function if last for more than 24 hours. In the United States, ischemic stroke affects 2.7% of men and 2.5% of women of age range 18 years and older. In addition, it has reported that annually about 610,000 and 185,000 of new strokes and recurrent strokes cases occur in US1. Moreover, it has reported that patients who have suffered from a stroke have more chances of recurrent stroke, Myocardial infarction, and death from vascular causes2. One of the risk factor of ischemic stroke is formation of plaque in the blood vessels causing blood clot3. Several randomized trials have also reported that antiplatelet medications are efficient in preventing recurrences of stroke in patients who had an incident of ischemic stroke. Antiplatelet medications for preventing recurrences of stroke are aspirin, combination of aspirin and extended-release dipyridamole, and clopidogrel alone4. It ha...
Endovascular stent graft repair is designed to help reinforce a weakened aorta. Endovascular surgery is performed inside the aorta using thin, long tubes called catheters to place a stent surrounded with a fabric liner. Endovascular stent grafting uses an endovascular stent graft to reinforce the wall of the aorta and to help keep the damaged area from rupturing and developing into a potentially serious health problem that can be fatal and cause massive internal bleeding.
It goes without saying that everyone’s health is important and should be taken care carefully. Everyone has heard of strokes before but many people do not really know its meaning, types, and the number of individuals of that dies due to this issue. According to Centers for Disease Control and Prevention (2015), strokes kills an average of 130,000 people a year and it is one of the most common deaths that happen in the United States. An average of 800,000 of people die from cardiovascular disease and strokes and it is also a reason of long-term disability (Centers of Disease Control and Prevention, 2015). Strokes, which can also be called cerebrovascular accident or CVA happen when the blood supply to the brain is interrupted or the blood vessel going towards the brain burst. Then part of the brain dies or become seriously injured because the brain cells do not receive oxygen and they eventually die. People’s lifestyle may also impact seriously on their health and increase the possibility of having a stroke. Some of the risk that can severely increase the cause of stroke would be high blood pressure, heart disease, diabetes, cigarette smoking, as well as strokes that
Heart Disease. Those two words often conjure images of an elderly man clutching his chest in a fit of pain and subsequently succumbing to a heart attack. Those two words describe the leading cause of death in Americans--nearly 25%1. Unfortunately, many specific heart problems fade away and fall under the umbrella of only two words. This research paper will discuss one of those heart problems, aortic dissection, in much more detail, than just two little words.
...lood Vessel Stents.” 1-3). Bypass surgery is another option; a blood vessel from somewhere in the body is used to go around the blocked artery. This completely bypasses the blocked artery, so it no longer becomes an issue. Thrombolytic therapy is a method that involves injecting a medication into the artery that will dissolve the clot and allow blood to pass freely through the artery (“Peripheral Artery Disease.” 3).
There are many heath risks associated with any medical procedure. Gastric bypass beyond a doubt helps people shed on average about half their original weight, however, with such a dramatic weight loss and decrease in stomach size comes substantive side effects. David Bjerklie emphasizes that “there are risks, including… patients [that]… developed nerve damage ranging from minor tingling in the feet to incapaciting pain and weakness,” but many of the problems can be avoided by taking proper care by enrolling in nutrition programs. In many cases people “complain of increased sensitivity or reduced tolerance to the effects of alcohol compared with their experience before the operation.
Strokes are not only the leading cause of mentally disabling adults, but they are also the third most common reason for deaths worldwide (Jarvis, 2012). In general, a stroke, also called a “cerebrovascular accident,” occurs when blood flow of the vascular system is blocked from reaching parts of the brain (Jarvis, 2012). There are two types of stroke, an ischemic stroke or a hemorrhagic stroke, and they differ in the way they affect the vascular system. An ischemic stroke is the most common type of stroke, accounting for 80 percent of all strokes, and it is due to a thrombus or embolus blocking blood vessels supplying the brain (Durukan & Tatlisumak, 2007). A hemorrhagic stroke is less common, but is caused by the rupturing of a blood vessel in the brain and causes bleeding (Jarvis, 2012).
Debate on the superiority of regional anesthesia to general anesthesia continues to date. Current literature does not support any difference in mortality between regional and general anesthesia. The largest randomized study to date highlighting this issue, the General Anesthesia Local Anesthesia (GALA) study group, demonstrated no significant difference amongst patients receiving local versus general anesthesia for carotid endarterectomy surgery45. Following that randomized clinical trial, a retrospective review of the American College of Surgeons National Quality Improvement Program (ACS-NSQIP) reported similar results46. In another report from the ACS-NSQIP focusing on endovascular aortic repair, a lack of difference in mortality amongst local anesthesia, spinal anesthesia or general anesthesia emerged47. Moreover, meta-analyses of regional anesthesia versus general anesthesia for total hip arthroplasty and total knee arthroplasty revealed no difference in mortality.48, 49
Question #3: What, if any, are the long term complications associated with these surgeries and do the benefits outweigh the risks?
It’s a risky, yet it makes one wonder if it were available, why not go to a real doctor who knows what they’re doing. There would be more of a chance of dying or being seriously injured if done the prior alternative method. Being specialist that knows what to do would be the safest way to go; this just leads furthermore into why it should remain legal.
The World Health Organisation (2013) explains that an Ischaemic stroke occurs as a result of a blood vessel becoming blocked by a clot, reducing the supply of oxygen to the brain and, therefore, damaging tissue. The rationale for selecting Mary for this discussion is; the author wishes to expand her evidenced based knowledge of stroke since it is the principal cause of disability and the third leading cause of mortality within the Scottish population (Scottish Intercollegiate Guidelines Network (SIGN), 2008) and, therefore, a national priority. In response to this priority, the Scottish Government (2009) produced their ‘Better Heart Disease and Stroke Care Action Plan’. Additionally, they have introduced a HEAT target to ensure 90% of stroke patients get transferred to a specialised stroke unit on the day of admission to hospital (Scottish Government, 2012).
These methods have been thoroughly researched on their own but a comparison study with similar patient populations would be the best way to show which method has better patient outcomes. The studies reviewed in this paper used patients of different acuity but had similar results. I think this means mechanical removal of the clot could be more efficacious that intravenous tPA in lower acuity stroke patients. I could not find research on this specific subject for comparison. I don’t often see patients past the point of initial treatment; therefore I don’t know the outcomes. I have seen many patients undergo each type of treatment for ischemic stroke, some begin to show improvement within the first hour of beginning tPA treatment in the ER. Without more research, I will continue to follow the AHA/ASA guidelines for tPA treatment in my clinical practice.
However, these side effects can be avoided with the proper amount of vitamin and mineral supplements. Up to 20 percent of patients who undergo the operation will require follow-up surgeries to correct complications. Common problems include abdominal hernias, breakdown of the staple line and stretched stomach outlets. There’s rapid regain of weight and all sorts of medical problems. From vitamin deficiencies to constant illness, stomach upsets, diarrhea, fatigue and horrible wound infections. Many people don’t want to admit they’ve had problems because they’re so happy to be thin; “People who have had the surgery the past couple of years are in a honeymoon state”, states Guthrie, Catherine. The author of “Bariatric Surgery: A Radical Obesity Fix. They is so thrilled to be thin. They believe being thin at all costs is more important than their own lives. Even if the patients have problems although these are some complications, most patients undergo only one surgery and there's an 85 percent success rate.