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“Dr.
Larson has a really good bedside manner. He just cared. He made you feel
comfortable and I appreciated his understanding ways. His personality is
great!”
—Betty
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Strokes are acute events that cause the brain to be
deprived of
oxygen. This can be caused from bleeding in the brain or a ‘blood
clot’ choking off the blood supply to brain tissue. Strokes are the
third leading cause of death, after heart disease and cancer. Non-fatal
strokes can cause considerable problems with paralysis and loss of
speech. Five percent of the population over age 65 will suffer a stroke.
The ‘blood clots’ that cause strokes can be blood clots from the heart,
or more commonly, pieces of cholesterol plaque that break off a
narrowing (stenosis) in the carotid artery in the neck.
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One good thing about strokes is that many are
preventable. Patients with atrial fibrillation are prone to develop
blood clots in the heart, and taking aspirin or coumadin decreases the
chance of a stroke. A narrowing in the carotid artery is termed carotid
stenosis, and often these blockages can be detected and corrected before
a stroke occurs. Carotid stenosis is usually diagnosed with a carotid duplex, a
simple and inexpensive ultrasound that can measure the narrowing in the
carotid artery.
The operation to remove a carotid stenosis (either before or after a
stroke) is a carotid endarterectomy. This is a 90 minute procedure
performed through an incision on the side of your neck. I have
considerable experience with these operations and have found that
performing them with local anesthesia is often safer, easier, and less
invasive to the patient. Patients can usually be discharged 24 – 48
hours after the procedure.
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Strokes can safely be prevented with carotid surgery -
this has been proven with several large, national studies. The
recommendations are that a surgeon with enough experience to maintain
good results and a low stroke rate perform these operations. My
fourteen-year experience of performing over 600 carotid endarterectomies has
yielded a stroke rate of less than one percent, which is as good as or
better than most University programs. I currently perform 60 - 100 of
these operations a year.
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The risk factors for vascular disease include smoking,
high blood
pressure, high cholesterol, and diabetes. Eliminating or reducing these
risk factors, as well as taking aspirin, can decrease your chance of a stroke.
If you are over 60 and have any of these risk factors, have your doctor
order a carotid duplex. If you already have
carotid stenosis, ask your doctor about having it fixed before a stroke
occurs.
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