Chronic Venous Insufficiency and Ulceration
Excessive Sweating (Hyperhidrosis)
Surgery for Carotid Artery Disease - Carotid Endartarectomy (CEA)
Carotid endarterectomy can usually be performed under local anaesthetic. The big advantage of having the patients awake is that if there is a problem with the blood supply to the brain during the operation it is obvious and something can be done about it. If the patient is asleep under general anaesthetic it is harder to tell if everything is alright.
Even in the best of hands, carotid endarterectomy is associated with a 2-3% risk of stroke, which may be severe and disabling, even fatal. For that reason, vascular surgeons are reluctant to operate on narrowings in the carotid arteries unless they are quite severe (usually greater than 70%) and have already caused symptoms (TIA or Amaurosis Fugax).
In some cases, surgeons will also recommend carotid endarterectomy when the narrowing is ‘asymptomatic’ (i.e. has not yet caused any symptoms) because the patient is believed to be at high risk without surgery. Such surgery is usually reserved for patients where the narrowing is very severe (e.g. > 90%) or one of the carotid arteries is already blocked on one side and there is a narrowing in the artery on the other side.