Carotid Endarterectomy Flashcards
Exam 2
What is a Carotid Endarterectomy?
A surgical procedure to plaque from the Common Carotid and Internal Carotid Arteries
Why is Local Anesthesia sometimes used during a Carotid Endarterectomy?
If patient is at risk for a stroke
-Patient is not asleep so team is able to monitor for strokes
True or False: Carotid Endarterectomies are performed on vessels that are less than 100% occluded.
True
What is Reperfusion Syndrome?
When a Carotid vessel is 100% occluded, the brain gets used to lack of oxygen
-Revascularization could shock the brain
What is Patient Positioning for a Carotid Endarterectomy?
- Supine with Bilateral Arms tucked
- Neck extended (Head in Jelly Ring)
- Shoulder roll under Axilla
- Head turned away from operative side
What are the key instruments used in a Carotid Endarterectomy?
- Potts Scissors
- Gerald Forceps
- Vessel Loops
- Carotid Shunt
- Fogarty Hydragrip Clamp
- Profunda Clamp
How much of the patient’s skin is prepped for a Carotid Endarterectomy?
From Ear to Clavicle
True or False: The tip of the earlobe is covered when draping for a Carotid Endarterectomy?
False
-The tip of the earlobe is left exposed for orientation
Which type of drape is used for a Carotid Endarterectomy?
Thyroid drape
- With four sterile towels
- With two towels to “build up” the neck
Where is the skin incision made for a Carotid Endarterectomy?
Parallel to the anterior border of the Sternocleidomastoid
Which type of retractor is used when dissecting the SCM for a Carotid Endarterectomy?
Dull Weitlaners
Why do we ligate the Facial Vein for a Carotid Endarterectomy?
It runs right over the Carotid Bifurcation
Why must you avoid DeBakey manipulation of the Carotid Sinus during a Carotid Endarterectomy?
Patient can go into Bradycardia due to stimulation of the Aortic Baroreceptors
What structure must be avoided when dissecting the Carotid Sheath during a Carotid Endarterectomy?
Hypoglossal Nerve (CN XII) -Runs right over the Carotid Bifurcation
What is given to the patient to prevent blood clotting during a a Carotid Endarterectomy?
5000 mL of Heparin
What is Clamp Order for a Carotid Endarterectomy?
- Common Carotid Artery
- External Carotid Artery
- Internal Carotid Artery
Why is the Internal Carotid Artery the last one clamped during a Carotid Endarterectomy?
We want as much blood to reach the brain before we start
What do we use to make the initial incision for the arteriotomy during a Carotid Endarterectomy?
#11 blade -Continue incision with Potts Scissors
What instrument is used to separate the plaque from the artery during a Carotid Endarterectomy?
Freer elevator
What is the Shunt Order during a Carotid Endarterectomy?
- Internal Carotid Artery
2. Common Carotid Artery
What is the SA’s role in Carotid Artery Shunting during a Carotid Endarterectomy?
Control clamps and suction
What suture is used to tack floating plaques to arterial walls during Carotid Endarterectomies?
5-0 Prolene
What suture is used on the patch that covers the arteriotomy during a Carotid Endarterectomy?
5-0 Prolene (C1 Needle)
-Running stitch
What is the SA’s role while suture the patch over the arteriotomy during a Carotid Endarterectomy?
Follow the suture
