The carotid artery carries blood through the neck to the brain. Blockage of this artery can lead to brain damage called a stroke.
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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If you are planning to have an endarterectomy, your doctor will review a list of possible complications, which may include: 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
Arteriogram—a type of x-ray in which a contrast material or dye is injected into the arteries to make them more visibleUltrasound—a test that uses sound waves to examine the carotid arteries
Magnetic resonance angiography (MRA) scan—a test that uses magnetic waves, along with a contrast agent, to make pictures of arteries
Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
The night before, eat a light meal. Do not eat or drink anything after midnight.
You and your doctor will discuss using either: General anesthesia—you will be asleep.
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 medicine to help prevent blood clotting.
Anesthesia will prevent pain during the procedure. You will be given medicine to help manage any pain.
The usual length of stay is 1-3 days. Your doctor may choose to keep you longer if complications occur.
The average recovery time is two weeks. When you return home, do the following to help ensure a smooth recovery: Keep your neck straight. Keep the head of your bed elevated during recovery.Take medicines as prescribed by your doctor. Anticoagulants will help to prevent blood clots. Prescription and nonprescription pain relievers will help with any discomfort.Resume your daily activities as soon as you are able.Do not drive for three weeks after surgery or until your doctor says it is okay.Avoid vigorous exercise for six weeks after surgery.
Make dietary changes to help prevent a return of plaque build-up.
Eat a diet low in saturated fat.
Make sure your diet is
high in fruits, vegetables,
grains, and fish. You may want to see a registered dietitian for help in making these changes.
Ask your doctor about when it is safe to shower, bathe, or soak in water.
Be sure to follow your doctor’s
After you leave the hospital, contact your doctor if any of the following occurs: Signs of infection, including fever and chillsRedness, swelling, increasing pain, excessive bleeding, or discharge at the incision siteNausea and/or vomiting that you cannot control with the medicines you were given after surgery, or which persist for more than two days after discharge from the hospitalPain that you cannot control with the medicines you have 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
In case of an emergency, call for medical help right away.
Ederle J, Brown MM. Managing carotid stenosis: carotid endarterectomy and stenting.
6/2/2011 DynaMed's Systematic Literature Surveillance
DynaMed's Systematic Literature Surveillance
: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis.
Am J Med.
Last reviewed May 2013 by Michael J. Fucci, DO; Michael Woods, MD
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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