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.
This procedure helps to restore proper blood flow to the brain. This will help to prevent strokes and transient ischemic attacks (TIAs) . TIAs are considered a warning sign of a coming stroke.
If you are planning to have an endarterectomy, your doctor will review a list of possible complications, which may include:
Factors that may increase the risk of complications include:
Your doctor may do the following:
Leading up to your procedure:
Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
You and your doctor will discuss using either:
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. The doctor may need to remove a section of the carotid artery. 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.
The doctor may do an arteriogram. This is to ensure that there are no complications, such as blood clots or narrowing. You may be given medicine to help prevent blood clotting.
2-4 hours
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 arise.
The average recovery time is two weeks. When you return home, do the following to help ensure a smooth recovery:
After you leave the hospital, contact your doctor if any of the following occurs:
In case of an emergency, CALL 911 .
RESOURCES:
American Heart Association
http://www.americanheart.org/
National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov/
CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca/
Heart and Stroke Foundation of Canada
http://www.heartandstroke.ca/
References:
American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=1200000 .
Cleveland Clinic. Carotid Endarterectomy. Available at: http://my.clevelandclinic.org/services/endarterectomy/vs_carotid_endarterectomy_overview.aspx . Accessed on January 11, 2009.
Ederle J, Brown MM. Managing carotid stenosis: carotid endarterectomy and stenting. Minerva Med . 2008 Oct;99(5):483-8.
Questions and answers about carotid endarterectormy. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov . Accessed January 12, 2009.
Last reviewed December 2009 by Craig Clark, DO, FACC, FAHA, FASE
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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