Carotid endarterectomy is a surgical procedure performed to remove plaque (deposits of fat) from the carotid arteries of the neck; the main blood vessels that supply blood to the brain.
Carotid endarterectomy is the most common treatment for carotid artery disease (CAD). The surgery is highly beneficial for people who have already had a stroke, or a transient ischemic attack (TIA). Surgery may also be recommended for individuals with severe narrowing of the carotid arteries without a history of any symptoms.
Preparing for surgery
Before having a carotid endarterectomy, you will receive specific instructions that help you prepare for the surgery. Most patients are on aspirin through the procedure but you will be asked to avoid certain medications before your surgery. A cerebral angiography, a diagnostic test that uses X-rays to produce detailed images of the blood vessels in your head, may be recommended before surgery.
The aim of the surgery is to reduce the risk of stroke by shunting or rerouting the blood flow to the brain. A carotid endarterectomy often takes about 1 ½ to 2 hours and is usually performed by a vascular surgeon. The procedure is performed in a hospital under general or local anaesthesia with intravenous sedation. During the surgery, an incision is made over the neck to expose the narrowed carotid artery. A plastic tube is placed into the blood vessel, above and below the narrowing or blockage, to re-route the blood flow around the narrowed or blocked area. The artery is then opened and the plaque is removed. The plastic tube is then removed and the artery and skin incisions are closed.
Recovery after a carotid endarterectomy is usually rapid and most patients are discharged home the next day after surgery. You may experience slight neck pain following the surgery, which is usually relieved with pain medications.
As with any type of surgery, there are some risks associated with a carotid endarterectomy which include infection, bleeding, blood clot formation, brain damage, and heart attack or stroke.
Factors such as severity of the carotid artery disease, location of the blockage, previous history of stroke, and other health conditions may increase your risk of complications from this surgery.
Carotid endarterectomy decreases the risk of brain damage and stroke. Adopting a healthy lifestyle can help prevent plaque build-up, blood clot formation, and other problems in the carotid arteries.