I am healing from a 2.5 hour procedure and now I see why a 97% occluded R. Carotid took what it took. My surgeons and their OR staff deserve a parade! Amazing, thank you for this fascinating video.
@@3081-wcc Oddly I had zero symptoms. My Cardiologist for some reason decided to use his stethoscope and check my Carotid arteries on a visit one year. He did it on a whim and I guess a hunch. The sounds he heard (or didn't hear?) gave him pause so he set up a consult for a sonogram and that led to surgery being scheduled. I had no idea there was an issue. As I mentioned, the surgery was 2.5 hours in duration. I woke in post op with a long bandage on my right side of my neck. The surgeon came in and checked on me. He had a small plastic specimen jar in his hand with what looked like a long thin line of bubblegum. I am guessing some of the marker chemicals made the Cholesterol look pink? He let me have it so I could look at it daily to help drive life choices from then on. I remember being sore for a while (days) then eventually I removed the bandages (per post op instructions) and had a long scraggly scar. Eventually that scar healed and straightened out. It looks like I have a dueling scar now. It took a while for the skin to stretch near the incision so my neck on that side felt tight for a while. Now, no worries. Hope that helps you.
This guy is pointing out the descending sub-marsupial transverse extra delineated proximal nerve cluster secondary to God knows what else, and I'm lookin' at a slab of meat. Thank GOD for the physicians, and aspiring physicians who comprehend this stuff, and devote themselves to mastering it. Guys like me are counting on you. God bless every one of you.
I should be doing my Med Surg homework but instead here I am. Once I read about endarterectomies I had to see one and ugh it's so satisfying and amazing to watch!
The Vascular Surgeon team that performed this surgery on me in PA on both carotid arteries did a magnificent job . Thank You ! Wish I had them for angioplasty but they no longer accepting my insurance 😭😭😭😭
I underwent this procedure 2 days ago. I am so grateful to Dr Stanton and his team. What an amazing operation, performed by a remarkable group of people. Left artery blocked 100%, right artery blocked 96%.
@@Willthethrill478 I'm 68 mate and I was informed by my surgeon, Dr Stanton, that in my case it was more likely to genetic. I feel heaps better and my vision is no longer playing up. The whole thing cost 16k and I think that's cheap to save my life. I don't have private health insurance and never have had and never will. We are very lucky here in Australia
@@Acme12345 I’m 55 and I too seem to have it hereditary. But mine is blocked below the internal/external carotid artery split, usually it’s just after the split. They are suggesting no surgery, keep it blocked as they don’t want to risk particles getting to my brain and cause stroke. I live in Boston with the best surgeons in the world so at this point just living with it
@@Willthethrill478 they also told me that they intend to leave the totally blocked side alone and not interfere with it, but I think I would rather have it done
Is your husband ok? Btw, the reason I'm here is because my favorite uncle may need this on both sides and they told him it was a very risky surgery and there was a good chance he could die from it. ☹
I’m a medical secretary for a vascular surgeon and I love watching the operations that are performed by him, because it helps me to understand what I’m typing about when I type our patients operation reports, super interesting 😀
@@lauracorbett3669 Let's not assume those are spelling mistakes (which implies wrong knowledge), instead of just typos (which could signify typing in a hurry and not going back to check). They're most likely typos because the letters "u and i" are adjacent on the keyboard. Also in "fisrt" there is just change in order of letters r and s. I don't understand why insulting typos is a thing on the internet.
What happens to the remaining plaque ? Other than a dacron patch , are there any other techniques to close the dissection? Can a stent be put to dissolve the plaque ?
Don’t know if anyone will read this but my sister’s left carotid is 75% blocked. She’s having a stenting procedure today. Her cardiologist literally left it to my brother and me to decide between stenting and endarterectomy. Our decision was based on the lesser invasiveness of stenting but now I’m wondering if we made the right decision (without proper education of the differences). Too late now, the stenting procedure is today.
@@HarishGovindarajan3092 She’s now living in assisted living, but has refused follow up medical visits. We’ve finally convinced her to see a doctor and have an appointment with a new cardiologist on September 7. Hopefully we’ll get a good report. Thank you for asking.
I'm 35 right now and am considering on getting this done in the future. I have a 100% occluded, shunted (from the mechanical valve installation) left carotid artery but my body already has collateral arteries bypassing that blockage. My medical history: -aortic dissection at age 33 -aortic arch type b reconstruction with a ON-X mechanical valve at age 34 -stroke in the left hemisphere of the brain at age 35 My stroke left me with very minimal or non-existent signs that I even had a stroke. The only residuals are having cloudy thoughts some times and "fast" speech. Most people that knew me would say that I'm the same before and after the stroke..
Wow. You are very young for this all to have happen to you. May I ask if you have ever been diagnosed with ehlers danlos syndrome, marfan syndrome or a dyslipidemia?
You’re so very, very fortunate to have minimal damage from your stroke. Your angels are watching over you. My sister had a stroke in July and today is having a carotid stenting procedure. The damage to her left hemisphere is severe and left her uncommunicative. She’s a widow with no children, so my brother and I made the decision of stenting over endarterectomy. We’re in OKC but if I could’ve gotten her to Methodist in Houston I’d prefer the endarterectomy route. Anyway I’m rambling bc I’m nervous for today! Best of luck.
@@truthteller2711 I'm assuming that due to the possible complications of the surgery and my lengthy medical history, the benefits would NOT justify the risk right? 🤨🤔
during the procedure when you are clamping the ICA, are you relying on posterior circulation for cranial perfusion? Sorry, i tried to do some googling and it just shows measures of perfusion during the operation
There is collateral circulation from circle of Willis, unless it also has stenosis and cannot compensate. They did mention that if the MCA flow velocity (using doppler)(MCA being a branch of the internal carotid artery) drops by 50%, they will insert a shunt, which wasn't needed in this patient.
@@Sandouras because the affected artery that is narrowed is at risk of suddenly developing small mini blood clots spontaneously and travel to the same side of brain and cause a stroke, which is like a timebomb. There are large medical trials done to see the benefits of doing this type of surgery in patients who have symptoms with very narrowed artery vs patients who just take medications. Needless to say, the patients with surgery had overall significant lower risk of death and strokes over 5 year period compared to those with no surgery. Trials names are NASCET (Northern american symptomatic carotid endarterectomy trial) and ECST (european carotid endarterectomy surgery trial).
I'm not exactly sure what a "shower" means, I'm looking into it, but the gist is to prevent damage to the brain by opening the internal carotid last. Which can happen due to the sudden rush of high pressure blood.
Remember this was caused by poor diet/exercise/health habits that stem from a combination of poor education/training on the topics along with 90% of your selection options being in the unhealthy category (that's without mentioning price or location disparities like food deserts where the problem is 10x worse) --> = socioeconomic disparities
Adding to this - cigarette smoking. I wish anatomy and physiology was a required course in every high school. It’s literally the only thing every one has in common - a body. If more people understood the basics of how their body works maybe they would make better health choices.
Such amazingly talented people. They are the true heroes in our society and not celebrities and media figures.
Yea I agree. I had the opportunity to observe operation in fluoroscopy and after that I would say they are not Doctors, they are Angels.
and dumb athletes
I am healing from a 2.5 hour procedure and now I see why a 97% occluded R. Carotid took what it took. My surgeons and their OR staff deserve a parade! Amazing, thank you for this fascinating video.
Could you please tell me about your symptoms and surgery. Now I’m struggling with this issue.
@@3081-wcc Oddly I had zero symptoms. My Cardiologist for some reason decided to use his stethoscope and check my Carotid arteries on a visit one year. He did it on a whim and I guess a hunch. The sounds he heard (or didn't hear?) gave him pause so he set up a consult for a sonogram and that led to surgery being scheduled. I had no idea there was an issue.
As I mentioned, the surgery was 2.5 hours in duration. I woke in post op with a long bandage on my right side of my neck. The surgeon came in and checked on me. He had a small plastic specimen jar in his hand with what looked like a long thin line of bubblegum. I am guessing some of the marker chemicals made the Cholesterol look pink? He let me have it so I could look at it daily to help drive life choices from then on.
I remember being sore for a while (days) then eventually I removed the bandages (per post op instructions) and had a long scraggly scar. Eventually that scar healed and straightened out. It looks like I have a dueling scar now. It took a while for the skin to stretch near the incision so my neck on that side felt tight for a while. Now, no worries. Hope that helps you.
Watching this before my Step exam as motivation. Nothing like looking at the light at the end of tunnel to pump you. Thanks
I'm a little late but I hope it went well!!!!
This guy is pointing out the descending sub-marsupial transverse extra delineated proximal nerve cluster secondary to God knows what else, and I'm lookin' at a slab of meat. Thank GOD for the physicians, and aspiring physicians who comprehend this stuff, and devote themselves to mastering it.
Guys like me are counting on you. God bless every one of you.
Thank you for helping a retired RN-OR, remember how skilled surgeons are & how complex procedures can be. Learned so much anatomy in OR. Well done
I should be doing my Med Surg homework but instead here I am. Once I read about endarterectomies I had to see one and ugh it's so satisfying and amazing to watch!
I enjoyed being in these surgeries at work.
The Vascular Surgeon team that performed this surgery on me in PA on both carotid arteries did a magnificent job . Thank You ! Wish I had them for angioplasty but they no longer accepting my insurance 😭😭😭😭
that's the problem with the US healthcare system. greedy insurance companies have everyone by the balls
I underwent this procedure 2 days ago. I am so grateful to Dr Stanton and his team. What an amazing operation, performed by a remarkable group of people.
Left artery blocked 100%, right artery blocked 96%.
How Old are you? My right is totally blocked
@@Willthethrill478 I'm 68 mate and I was informed by my surgeon, Dr Stanton, that in my case it was more likely to genetic. I feel heaps better and my vision is no longer playing up. The whole thing cost 16k and I think that's cheap to save my life. I don't have private health insurance and never have had and never will. We are very lucky here in Australia
@@Acme12345 I’m 55 and I too seem to have it hereditary. But mine is blocked below the internal/external carotid artery split, usually it’s just after the split. They are suggesting no surgery, keep it blocked as they don’t want to risk particles getting to my brain and cause stroke. I live in Boston with the best surgeons in the world so at this point just living with it
@@Willthethrill478 mine was before the split also, I'm glad they did the operation otherwise I'd be dead
@@Willthethrill478 they also told me that they intend to leave the totally blocked side alone and not interfere with it, but I think I would rather have it done
very useful to watch before my husband's surgery
Hi
How is ur husband now? I hope hes all alright
Is your husband ok? Btw, the reason I'm here is because my favorite uncle may need this on both sides and they told him it was a very risky surgery and there was a good chance he could die from it. ☹
Long ago our surgery professor had already done more than 5000 of these. Nice dissection.
This surgeon and his discourse is superb and succinct. Bravo
Amazing how precise and skilled surgeons are, be blessed 🙏🏽
Got here from studying for my ultrasound board and I am simply amazed.
I’m a medical secretary for a vascular surgeon and I love watching the operations that are performed by him, because it helps me to understand what I’m typing about when I type our patients operation reports, super interesting 😀
Very impressive. Also glad you avoided the word "Oops!"
Insane. Awesome video. Thank you
I have zero clue what I just watched but damnnzzz surgeons are freaking AWESOME!!!!!!!!!!!
Very educational and helpful. Thank you.
Our Creator & those he allows these gifts are totally AWESOME👏💪💕🙏
Very impressive !!
I'm going to assist in this sirgery for the fisrt time with a neurosurgeon that's why I'm here
Maybe you should spell surgery right first
@@lauracorbett3669 Let's not assume those are spelling mistakes (which implies wrong knowledge), instead of just typos (which could signify typing in a hurry and not going back to check).
They're most likely typos because the letters "u and i" are adjacent on the keyboard. Also in "fisrt" there is just change in order of letters r and s.
I don't understand why insulting typos is a thing on the internet.
Oh my God this is amazing, am really enjoying this 😃😃
Psycho 😂
What happens to the remaining plaque ? Other than a dacron patch , are there any other techniques to close the dissection?
Can a stent be put to dissolve the plaque ?
Don’t know if anyone will read this but my sister’s left carotid is 75% blocked. She’s having a stenting procedure today. Her cardiologist literally left it to my brother and me to decide between stenting and endarterectomy. Our decision was based on the lesser invasiveness of stenting but now I’m wondering if we made the right decision (without proper education of the differences).
Too late now, the stenting procedure is today.
How is she doing?
@@HarishGovindarajan3092 She’s now living in assisted living, but has refused follow up medical visits. We’ve finally convinced her to see a doctor and have an appointment with a new cardiologist on September 7. Hopefully we’ll get a good report. Thank you for asking.
On long run Endarterectomy is good option whith stenting procedure after some year symptoms will reoccur & possibility of stroke
What about your sister health?. I am also struggling with this problem and I am so worried and scared. Did your sister feel better.?
I'm 35 right now and am considering on getting this done in the future. I have a 100% occluded, shunted (from the mechanical valve installation) left carotid artery but my body already has collateral arteries bypassing that blockage. My medical history:
-aortic dissection at age 33
-aortic arch type b reconstruction with a ON-X mechanical valve at age 34
-stroke in the left hemisphere of the brain at age 35
My stroke left me with very minimal or non-existent signs that I even had a stroke. The only residuals are having cloudy thoughts some times and "fast" speech. Most people that knew me would say that I'm the same before and after the stroke..
Wow. You are very young for this all to have happen to you. May I ask if you have ever been diagnosed with ehlers danlos syndrome, marfan syndrome or a dyslipidemia?
Wow
You’re so very, very fortunate to have minimal damage from your stroke. Your angels are watching over you.
My sister had a stroke in July and today is having a carotid stenting procedure. The damage to her left hemisphere is severe and left her uncommunicative. She’s a widow with no children, so my brother and I made the decision of stenting over endarterectomy. We’re in OKC but if I could’ve gotten her to Methodist in Houston I’d prefer the endarterectomy route.
Anyway I’m rambling bc I’m nervous for today! Best of luck.
Not necessary if it’s 100% occluded
@@truthteller2711 I'm assuming that due to the possible complications of the surgery and my lengthy medical history, the benefits would NOT justify the risk right? 🤨🤔
I love yal, you're the Best! 🤘🏾-town 💯
I wish surgery videos show exactly on the body where incisions are made and their size. Isn't there a less invasive plaque removal surgery?
How much pain after the procedure?
what happens to the facial vein?
That was hard to watch, but worth watching.
Is it ok if you ligate the facial vein? Doesn't the patient need that?
From soap cutting to pimple popping to this.
I need help.
Same
Do you clamp the contra lateral carotid ? - Patel, MD
I love your handle name 😂
during the procedure when you are clamping the ICA, are you relying on posterior circulation for cranial perfusion? Sorry, i tried to do some googling and it just shows measures of perfusion during the operation
posterior and other carotid as well
Did they reconnect the facial nerve??
It was a facial vein not a nerve.
Don’t you create ischemia when you clamp the arteries for the operation?
Sandouras pretty sure that’s why they only do this surgery if your artery is more than 70% blocked. Just my guess
There is collateral circulation from circle of Willis, unless it also has stenosis and cannot compensate.
They did mention that if the MCA flow velocity (using doppler)(MCA being a branch of the internal carotid artery) drops by 50%, they will insert a shunt, which wasn't needed in this patient.
@@ngshinann But then, why operate the Carotid, you have the circle of Willis to compensate. Right? I dont know....
@@Sandouras because the affected artery that is narrowed is at risk of suddenly developing small mini blood clots spontaneously and travel to the same side of brain and cause a stroke, which is like a timebomb. There are large medical trials done to see the benefits of doing this type of surgery in patients who have symptoms with very narrowed artery vs patients who just take medications. Needless to say, the patients with surgery had overall significant lower risk of death and strokes over 5 year period compared to those with no surgery.
Trials names are NASCET (Northern american symptomatic carotid endarterectomy trial) and ECST (european carotid endarterectomy surgery trial).
@@ngshinann Thanks a lot for the answer mate!
Just got surgery i few days ago
Hoping you are well now. Complex surgery.
Really great video and educational, thank you so much.
After this i'm stopping consuming any mc donalds or burger king
One more question - is the fat layer in this patient typical? It looked like a lot of fat to me but it’s the first procedure I’ve watched.
Neat Work 👏🏼👏🏼👏🏼
great case...great case
emmm, when the facial vein was cut what happen to the patient face? can they still control their face muscles or do they still have expression?
Muscles are controlled by nerves, not veins
@@thelst9084
Wut?
Mine is 50 to 71 block on right. Left is 30. Do I need surgery. I had a stroke May 12,2019. I’m scared.
I think only your physician can answer the question.
I see this was two years ago.
I LOOOVE IT, I AM A MEDICAL STUDENT AMD SUCH ENCOURAGE ME TO DREAM TO BE A VASCULAR SURGEON! TY!
I work out all the time. I'm even tweaking my diet, slowly, over time, to make it even healthier.
OK what was the shower to the face not shower brain something.... Spoke too fast, I couldn't grasp it 🤷🏾♀️... ICE
I'm not exactly sure what a "shower" means, I'm looking into it, but the gist is to prevent damage to the brain by opening the internal carotid last.
Which can happen due to the sudden rush of high pressure blood.
I have a vascular physiology exam in 2 days days why am I here
“I can’t find my watch, Dr”
Mom is having that on the 15th of January.
Is she doing fine ? I'm just dealing with scar tissue I think . I'll know next week.....my surgeries were 4-18 and 7-18
私はビックマックを食べたくなったら、この動画を見てそれを止めている。
😂 🎉
respect
Wow❤
It is a very delicate and complex surgery. Without this, person was at high risk for CVA( stroke) or worse
Nice..
Remember this was caused by poor diet/exercise/health habits that stem from a combination of poor education/training on the topics along with 90% of your selection options being in the unhealthy category
(that's without mentioning price or location disparities like food deserts where the problem is 10x worse)
--> = socioeconomic disparities
Adding to this - cigarette smoking.
I wish anatomy and physiology was a required course in every high school. It’s literally the only thing every one has in common - a body. If more people understood the basics of how their body works maybe they would make better health choices.
So cool
I like watching these lol
Dude this is my worst nightmare
واااو😍
❤
Kid sounds like he is 15...
Yet he's a doctor but you're not.
Wtf