Carotid Endarterectomy

A carotid endarterectomy is a procedure that is used to treat carotid artery disease. This disease is the result of the accumulation of fatty or waxy deposits in one of the carotid arteries.

The carotid arteries are blood vessels located on each side of your neck. This buildup of plaques (atherosclerosis) may restrict blood flow to your brain.

Removing plaques causing the narrowing of the artery can improve blood flow in your carotid artery and reduce your risk of stroke.

Your vascular surgeon may recommend you to have a carotid endarterectomy for the following reasons:

• A moderate (50t0n79%) blockage of the carotid artery and experiencing symptoms like stroke, mini-stroke or TIA (transient ischemic attacks).
• A severe (80% or more) blockage even if you are not showing any symptoms.

A carotid endarterectomy carries the following risks:

• Stroke: Stroke occurs in 2-3% of patients who do not have any pre-procedure symptoms; in 5-7% of patients with pre-procedure symptoms such as stroke, mini-stroke or TIA (transient ischemic attack). 

  After the procedure, you will be asked to move your arms and legs and will be examined by nurses and doctors to make sure that you have not had any new stroke symptoms.

• Heart attack.
• Nerve damage, affecting your voice box, tongue or back.

In order to prepare for a carotid endarterectomy, discuss your condition with your family members or any other individuals you have designated to take part in medical decisions.

Ask your vascular surgeon whether to continue or modify scheduled medications.

Here’s what you can expect before, during, and after your carotid endarterectomy procedure.

A carotid endarterectomy is usually performed in a sterile surgical suite or standard operating room. It can be an outpatient procedure in some cases, but you can stay in the hospital for 1-2 days depending on your medical condition.

• You receive local or general anesthesia.
• Your vascular surgeon makes an incision in front of your neck.
• After removing the plaque from the artery, your vascular surgeon will proceed to repair the artery by stitching in a natural raft (formed from a piece of vein from elsewhere in your body) or woven patch.
• The incision is then closed.

Doctors can determine if you are a candidate for a procedure called carotid angioplasty and tenting instead of a carotid endarterectomy. In this procedure, doctors thread a thin tube (catheter) with a small balloon attached to a blood vessel in your neck to the narrowed artery.

The balloon is then inflated to widen the artery and a small wire mesh coil (stent) is often inserted to keep the artery from narrowing again.

Understanding the results of your carotid endarterectomy will be made possible by your doctor.

Expect to be in the hospital for 1-2 days, it can be longer if complications develop, in which case stay at a rehabilitation center may be required.

You will have a sore throat and the skin around the incision on your neck will be numb. This usually improves over time.

You will see your vascular surgeon and will undergo a carotid ultrasound to look at the artery. This process will be done on a yearly basis to make sure the plaque has not accumulated again.

You may wish to eat smooth soft foods like soup and yogurt for a while before returning to your regular diet.

Driving is usually permitted once the pain medication is stopped and you can easily turn your head to check our surroundings on the road and safely merge with traffic.