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endarterectomy

 
Medical Encyclopedia: Endarterectomy

Definition

Endarterectomy is an operation to remove or bypass the fatty deposits, or blockage, in an artery narrowed by the buildup of fatty tissue (atherosclerosis).

Description

Carotid artery disease

Every person has four carotid arteries (the internal and external carotids on each side of the neck) through which blood from the heart moves into the brain. If one of these arteries becomes blocked by fat and cholesterol, the patient may have a range of symptoms, including:

  • weakness in one arm, leg, half of the face, or one entire side of the body
  • numbness tingling
  • paralysis of an arm, leg, or face
  • slurred speech
  • dizziness
  • confusion, fainting, or coma
  • stroke

Removing this fatty buildup, or bypassing a blocked segment, may restore blood flow to the brain, eliminate or decrease the symptoms, and lessen the risk of a stroke.

Peripheral vascular disease

When the blood vessels in the legs (and sometimes the arms) become narrowed, this can restrict blood flow and cause pain in the affected area. In severe cases, the tissue may die, requiring amputation.

The narrowing is usually caused by buildup of fatty plaques in the vessels, often as the result of smoking, high blood pressure, or poorly-controlled diabetes mellitus. The vessels usually narrow slowly, but it's possible for a blood clot to form quickly, causing sudden severe pain in the affected leg or arm.

Procedure

Endarterectomy is a delicate operation that may require several hours. The surgeon begins by making an

incision over the blocked artery and inserting a tube above and below the blockage to redirect the blood flow while the artery is opened.

Next, the surgeon removes the fat and cholesterol buildup, along with any blood clots that have formed, with a blunt dissecting instrument. Then the surgeon bathes the clean wall in salt solution combined with heparin, an anticoagulant. Then the surgeon stitches the artery just enough so that the bypass shunt tube can be removed, and then he/she stitches the artery completely closed. After checking to make sure no blood is leaking, the surgeon next closes the skin incision with stitches.

The operation should improve symptoms, although its long-term effects may be more limited, since arterial narrowing is rarely confined to one area of one artery. If narrowing is a problem throughout the body, arterial reconstructive surgery may be required.

The total cost of an endarterectomy, including diagnostic tests, surgery, hospitalization, and follow-up care, will vary according to hospital, doctor, and area of the country where the operation is performed, but a patient can expect to pay in the range of $15, 000. Patients who are very young, very old, or very ill, or who need more extensive surgery, may require more expensive treatment.

— Carol A. Turkington



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Dictionary: end·ar·te·rec·to·my
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(ĕn'där-tə-rĕk'tə-mē) pronunciation
n., pl., -mies.
Surgical excision of the inner lining of an artery that is clogged with atherosclerotic buildup.

[New Latin endartērium, inner lining of an artery (ENDO- + Latin artēria, artery; see artery) + -ECTOMY.]


Veterinary Dictionary: endarterectomy
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Excision of thickened atheromatous areas of the innermost coat of an artery.

  • carotid e. — endarterectomy within an extracranial carotid artery, usually within the common carotid. See also carotid endarterectomy.
Wikipedia: Endarterectomy
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Intervention:
Endarterectomy
ICD-10 code:
ICD-9 code: 38.1
MeSH D004691
Other codes:

Endarterectomy is a surgical procedure to remove the atheromatous plaque material, or blockage, in the lining of an artery constricted by the buildup of soft/hardening deposits. It is carried out by separating the plaque from the arterial wall.

It was first performed on a superficial femoral artery in 1946 by the Portuguese surgeon João Cid dos Santos. In 1951, E. J. Wylie, an American, performed it on the abdominal aorta. The first successful reconstruction of the carotid artery was performed by Carrea, Molins, and Murphy in Argentina, later in the same year.[1]

The procedure is widely used on the carotid artery of the neck as a way to reduce the risk of stroke, particularly when the carotid artery is narrowed by more than 70%. A carotid endarterectomy may itself cause a stroke at the time of operation.

Endarterectomy is also used as a supplement to a vein bypass graft to open up distal segments.

Some forms of pulmonary hypertension may be amenable to endarterectomy of the pulmonary artery. This is a highly specialized procedure.

The term atherectomy is used to describe reconstruction through a catheter.

See also


References

  1. ^ Thompson, Jesse E., The Evolution of Surgery for the Treatment and Prevention of Stroke (retrieved on 2007-04-24)

External links



 
 

 

Copyrights:

Medical Encyclopedia. © 2006 through a partnership of Answers Corporation. All rights reserved.  Read more
Dictionary. The American Heritage® Dictionary of the English Language, Fourth Edition Copyright © 2007, 2000 by Houghton Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company. All rights reserved.  Read more
Veterinary Dictionary. Saunders Comprehensive Veterinary Dictionary 3rd Edition. Copyright © 2007 by D.C. Blood, V.P. Studdert and C.C. Gay, Elsevier. All rights reserved.  Read more
Wikipedia. This article is licensed under the Creative Commons Attribution/Share-Alike License. It uses material from the Wikipedia article "Endarterectomy" Read more