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Suturing Technique for a Carotid Endarterectomy

Carotid endarterectomy is used to treat atherosclerosis in carotid arteries of the neck. This involves extracting plaque from the artery, cutting out parts of the artery, and joining the arteries together. A portion of the saphenous vein of the leg is used in extreme cases in order to repair the carotid artery. Suturing techniques involve several steps during the carotid endartectomy.

  1. Incision

    • A cervical nerve block is performed on the patient before surgery begins. An incision of 4-5 cm is made on the anterior border of a muscle called the sternocleidomastoid. This muscle and the internal jugular vein are retracted to expose the carotid. In order to detect precisely where the plaque is located, surgeons look for a yellowish discoloration and an incompressible artery wall.

    Excision of Atheroslerotic Carotid Artery

    • Once the atherosclerotic section of the carotid is identified, the surgeon makes a 5- to 10-mm excision between the ends of the section. Once the atherosclerotic portion is removed, the surgeon joins the common carotid with the internal carotid. A polypropylene suture is used in a continuous fashion for this because the outer layer of the carotid artery is extremely delicate.

    Outcome

    • Surgeons have performed carotid endarterectomy and been successful in terms of not seeing the occurrence of stenosis or narrowing of the vessel. Stenosis can often lead to turbulent blood flow through the artery, leading to complications such as blood clots or strokes.

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