Carotid Surgery

Carotid Surgery is a critical vascular specialty dedicated to the prevention and treatment of cerebrovascular events caused by carotid artery stenosis and occlusive disease. As a prominent topic within a global Surgery Conference, this session examines contemporary operative strategies, stroke prevention protocols, and innovations in carotid endarterectomy and arterial reconstruction. With ischemic stroke remaining a leading cause of disability and mortality worldwide, timely and precise surgical intervention plays a pivotal role in reducing neurological complications.

The primary indication for carotid intervention is significant narrowing of the internal carotid artery, often due to atherosclerotic plaque formation. Surgical management focuses on restoring adequate cerebral perfusion while minimizing procedural risk. Carotid endarterectomy remains the gold standard for many patients with symptomatic or high-grade asymptomatic stenosis. Careful patient selection, based on imaging findings and risk stratification, ensures optimal outcomes. Duplex ultrasonography, CT angiography, and MR angiography assist in accurate preoperative assessment and operative planning.

Technical precision during surgery is essential to prevent embolization and maintain cerebral protection. Techniques such as patch angioplasty and eversion endarterectomy are employed to reduce restenosis rates and ensure durable vessel patency. Intraoperative cerebral monitoring, including EEG and cerebral oximetry, enhances safety by detecting ischemic changes in real time. Advances in anesthesia management and perioperative blood pressure control further contribute to improved neurological outcomes.

This session also addresses alternative and complementary strategies, including carotid artery stenting in selected high-risk patients. Comparative outcome data between open surgical and endovascular approaches are evaluated to guide individualized treatment planning. Postoperative management emphasizes antiplatelet therapy, risk factor modification, and long-term vascular surveillance to prevent recurrence.

Emerging research focuses on plaque morphology analysis, personalized stroke risk prediction models, and minimally invasive vascular access techniques. Multidisciplinary collaboration between vascular surgeons, neurologists, cardiologists, and radiologists ensures comprehensive patient care. By integrating evidence-based practice with technological innovation, carotid interventions continue to advance as a cornerstone in stroke prevention and vascular surgical excellence.