Ian Loftus: Carotid Artery Surgery

The carotid arteries supply blood to the brain. Narrowing of the carotid arteries is a common cause of stroke and mini-stroke (transient ischaemic attacks or TIA). TIAs are often warning signs that a permanent stroke may be about to occur and urgent assessment is advised. Ian has a specific research interest in carotid disease and has published and presented work internationally. He is the lead carotid surgeon at St Georges Hospital, and has performed hundreds of carotid operations.

Patients with suspected carotid disease are assessed with a detailed medical history and full physical examination. This is followed by an ultrasound scan of the neck (called Duplex scan). This is entirely painless and involves placing a probe on the side of the neck to view the underlying arteries. If necessary, surgery may be indicated to treat any narrowing of the artery. The operation is called ‘carotid endarterectomy’ and involves removing the narrowing in the affected artery, and widening the artery to prevent a recurrence of the problem. Carotid endarterectomy may be performed under local or general anaesthesia according to patient preference. Surgery usually involved a 2 day stay in hospital.

There is a small risk of a stroke around the time of the operation (around 1%). A number of techniques are used to prevent this including monitoring the blood supply to the brain during the procedure and thinning of the blood. All of the potential risks- and benefits of surgery- will be discussed in detail prior to any treatment taking place.

Duplex scan