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Cerebrovascular Surgery

Our medical team at Bay Surgical Specialists understands that having cerebrovascular surgery can feel overwhelming.  Our care team will walk patients through their diagnosis, procedure, and post-procedure care.

Cerebrovascular surgery can be preventative or in response to a cerebrovascular accident, such as a stroke. Identifying and treating carotid artery disease is critical.

What is carotid arterial disease? Carotid artery stenosis (also called carotid artery disease) affects the vessels, blood flow and oxygen flow leading to the brain.  Plaque build-up (known as atherosclerosis) can lead to reduced blood flow, reduced oxygen to the brain, clots, and pose a risk for a transient ischemic attack (TIA) or stroke.  Removing the plaque can improve the blood flow and reduce the chance of stroke. Our cerebrovascular surgeons can perform a carotid endarterectomy to remove the plaque that has accumulated inside the carotid arteries in the neck.

What is an endarterectomy?  It is when the inner lining of an artery and obstructive deposits in the artery are removed or repaired to allow for normal blood flow.  When a blockage is removed from the carotid artery, this is called a carotid endarterectomy.

This surgery is most often performed under a local pain blocker or under general anesthesia in a hospital.  During the procedure, a small incision is made in the neck near the blockage.  The surgeon will repair the artery that is blocked by removing the plaque.  Our surgeons use dependable, modern techniques to safeguard the surgery area and minimize cosmetic scarring. 

Patients can expect to recover in the hospital for one or two nights following the surgery.  Our medical team will walk patients through the entire surgery, the risks, and benefits from a carotid endarterectomy.    

The degree of plaque blockage and other factors will determine the procedure the doctor will perform. In addition to the carotid endarterectomy, our Bay Surgical Specialists surgeons may advise a carotid artery angioplasty and stenting or a TransCarotid Artery Revascularization (TCAR). 

A carotid angioplasty is a minimally-invasive procedure that is performed under general anesthesia that uses a balloon-tipped catheter to correct blood flow issues. A surgeon will feed the balloon to the blockage and inflate it. This opens the blood vessel and improves blood flow.  Sometimes a stent is required to keep the vessel open.  There are many types of stents and our care team can discuss the benefits and risks of an angioplasty and stent.

A TransCarotid Artery Revascularization (TCAR) is a minimally-invasive procedure that helps to prevent debris (or emboli) from entering the brain.  Unlike a traditional angioplasty, the TCAR procedure redirects blood flow to keep the artery from transporting debris from traveling towards the brain.  The brain is fed by multiple arteries and temporarily changing the blood flow through the carotid artery is safe.  Similar to traditional angioplasties, the surgeon will make a small incision and work within the carotid vessel.  An angioplasty is performed and a stent put in.  The plaque and any debris flows away from the brain and into a filter.  Removing the small debris reduces the occurrence of small brain infarctions post-procedure. 

Have more questions about cerebrovascular surgery? Contact our care team today.


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