The carotid artery carries blood through the neck to the brain. Blockage of this artery can lead to brain damage called a
A carotid artery endarterectomy is a surgery to remove the deposits from this artery. Deposits in arteries result in plaque. This can slow and even stop blood from flowing through the artery.
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This procedure helps to restore proper blood flow to the brain. This will help to prevent
transient ischemic attacks
(TIAs). TIAs are mini-strokes and considered a warning sign for a future stroke.
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like: BleedingInfectionDamage to the carotid arteryHigh blood pressure
or low blood pressure
StrokeNerve injury in the neck
Factors that may increase the risk of complications include: SmokingThe degree of blockage in your carotid arteryBlockage of the carotid arteries on both sides of your neckDiabetes
Your doctor may do the following: Blood and urine testsElectrocardiogram
(EKG)—a test that records the heart's activity by measuring electrical currents through the heart muscle
Imaging tests to assess the arteries include:
ArteriogramUltrasoundMR angiography scan
Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
The night before, eat a light meal. Do not eat or drink anything after midnight.
will keep you asleep during the procedure
anesthesia—the area will be numbed
You will lie flat on a table. A roll will be placed under your shoulder. Your head will be turned to the side. A cut in the skin will be made along the side of the neck. The cut will run from just behind the ear to a point above the breastbone. Clamps will be placed above and below the plaque on the carotid artery. In some cases, a temporary bypass tube will be used to maintain blood flow around the area that is being operated on.
The artery will be opened and cleaned of plaque. The artery will then be sewn back together. The clamps, and bypass tube, if used, will then be removed. A section of the carotid artery may need to be removed. In this case, an artificial graft or a segment of vein will be sewn in to replace it. The neck incision will be closed with stitches.
arteriogram may be done to ensure that there are no complications, such as blood clots or narrowing. You may be given medication to help prevent blood clotting.
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
The usual length of stay is 1-3 days. Your doctor may choose to keep you longer if complications occur.
It may take up to 2 weeks to recover. Slowly return to normal activity as tolerated. You may be referred to a dietitian who can help with dietary changes. These changes will help prevent a return of plaque build-up. Changes focus on
a diet low in saturated fat
Make sure your diet is
high in fruits, vegetables
, and fish.
It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor: Signs of infection, including fever and chillsRedness, swelling, increasing pain, excessive bleeding, or discharge at the incision sitePersistent nausea and/or vomitingPain that you cannot control with the medications you've been givenSevere headaches, swelling in your neck, or other new symptomsCough, shortness of breath, chest painMemory lossDrooping facial musclesDifficulty with speech, vision, or with movingWeaknessArm painExtreme sweatinessLightheadedness or fainting
If you think you have an emergency, call for medical help right away.
Stroke treatments. American Heart Association website. Available at:
http://www.strokeassociation.org/STROKEORG/AboutStroke/Treatment/Stroke-Treatments_UCM_310892_Article.jsp. Updated November 21, 2012. Accessed May 6, 2013
Carotid endarterectomy. Cleveland Clinic website. Available at:
Updated June 2011. Accessed May 6, 2013.
Ederle J, Brown MM. Managing carotid stenosis: Carotid endarterectomy and stenting.
Questions and answers about carotid endarterectomy. National Institute of Neurological Disorders and Stroke website. Available at:
http://www.ninds.nih.gov/disorders/stroke/carotid_endarterectomy_backgrounder.htm. Updated July 5, 2012. Accessed May 6, 2013.
6/2/2011 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Mills E, Eyawo O, et al. Smoking cessation reduces postoperative complications: A systematic review and meta-analysis.
Am J Med.
Last reviewed December 2014 by Michael J. Fucci, DO
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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