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Carotid Endarterectomy

Carotid endarterectomy is a surgical cardiology procedure performed to prevent strokes in people with severe stenosis, or plaque buildup in the carotid artery that delivers blood to the brain.

What to Expect During Carotid Endarterectomy

  • During a carotid endarterectomy your doctor removes plaque from the carotid artery through an incision in the neck. This surgery has very low risk of stroke or complication.
  • You may be asleep under general anesthesia during surgery, or awake, with local anesthesia to control pain. This will be discussed with you before surgery. During the procedure:
  • Your doctor makes an incision in the skin over the carotid artery.
  • Your doctor places clamps on the artery above and below the blockage. This temporarily stops blood flow.
  • Next, your doctor makes an incision in the artery itself A shunt may be used to preserve blood flow to the brain during the procedure. After the shunt is in place, your doctor will remove the clamps from the internal carotid artery. In some cases a shunt is not needed because the brain is receiving enough blood through other arteries.
  • Your heart doctor loosens plaque from the artery wall. The plaque is then removed, often in a single piece. The surgeon inspects the artery to confirm that all of the plaque has been removed. He then closes the incision using either sutures or a patch.
  • Your doctor may suture (stitch) the incision closed. The clamps are then removed. Next, the skin incision is sutured closed. A tube (drain) may be put in place to keep fluids from collecting around the area.
  • Your doctor may close the artery with a patch of strong, flexible fabric. The clamps are then removed, the skin incision is sutured, and a drain may be put in place.

Recovery After Carotid Endarterectomy

  • Carotid endarterectomy typically involves a quick recovery with little pain.
  • You may stay in the hospital for one to two days. During this time, your physician will monitor your progress.
  • You will receive fluid and nutrients through a small, thin tube called an intravenous (IV) catheter. Because the neck incision is so small, you may not feel significant pain.
  • Your physician may recommend that you avoid driving and limit physical activities for several weeks.
  • You can usually begin normal activities again several weeks after the operation.

After your surgery, call your doctor if you:

  • Notice any change in brain function
  • Have severe headaches
  • Experience swelling in your neck