37605 Ligation; internal or common carotid artery

Name of the Procedure:

• Common Name: Carotid artery ligation
• Medical Term: Ligation of the internal or common carotid artery

Summary

Carotid artery ligation is a surgical procedure that involves tying off the internal or common carotid artery to prevent blood flow. This is typically done to treat conditions like aneurysms, severe bleeding, or tumors that cannot be managed with less invasive methods.

Purpose

• Medical Conditions: Aneurysms, tumors, severe bleeding, or arterial damage.
• Goals: To stop excessive bleeding, prevent aneurysm rupture, or reduce blood flow to a tumor.

Indications

• Symptoms like intense headaches, neck pain, pulsatile masses, or episodes of severe bleeding.
• Presence of an aneurysm, tumor, or arterial injury detected through diagnostic imaging.
• Patients for whom less invasive procedures are not viable.

Preparation

• Pre-procedure Instructions: Fasting for at least 8 hours before the surgery, and possibly adjusting or stopping certain medications as advised by the doctor.
• Diagnostic Tests: Imaging studies like CT scans, MRIs, or angiograms to pinpoint the exact location and severity of the problem.

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made in the neck to access the carotid artery.
3. The surgeon carefully isolates the artery.
4. A specialized surgical thread or clip is used to tie off (ligate) the artery.
5. The incision is closed with sutures or staples.

• Tools Used: Scalpels, surgical clips or threads, and imaging technology for guidance.
• Anesthesia: General anesthesia to ensure the patient is unconscious and pain-free.

Duration

The procedure typically takes 2 to 3 hours.

Setting

The surgery is performed in a hospital operating room.

Personnel

• Surgeon: Performs the ligation.
• Anesthesiologist: Manages anesthesia.
• Surgical Nurses: Assist the surgeon and manage the surgical environment.

Risks and Complications

• Common Risks: Infection, bleeding, or a reaction to anesthesia.
• Rare Risks: Stroke, nerve damage, or failure to control the bleeding.

Benefits

• Expected Benefits: Relief from symptoms, prevention of aneurysm rupture, or control of severe bleeding.
• Timeline: Benefits can be immediate in emergencies or seen over a few days to a week.

Recovery

• Post-procedure Care: Monitoring in a recovery room, pain management, and wound care.
• Recovery Time: Usually a few weeks, with follow-up appointments to monitor healing.
• Restrictions: Limiting physical activity and avoiding strenuous tasks.

Alternatives

• Other Options: Endovascular treatments like stenting or embolization.
• Pros/Cons:
  • Stenting: Less invasive but may not be suitable for all patients.
  • Embolization: Effective but can have its own set of risks.

Patient Experience

• During Procedure: The patient will be unconscious due to general anesthesia.
• After Procedure: Some pain and swelling around the incision site, managed with pain medications. Regular monitoring and gradual return to normal activities as advised by the doctor.