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Carotid Artery Endarterectomy

Authors:
  • Amy Scholten, MPH
Publication Type:

Procedure

Carotid Artery Endarterectomy

Definition

A carotid artery endarterectomy is surgery to remove fatty buildup (plaque) from this artery. The carotid artery brings blood through the neck to the brain. Plaque buildup can slow down and stop blood from flowing through the artery.

Carotid Artery.

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Reasons for Procedure

This procedure helps restore proper blood flow to the brain. This will help prevent strokes and transient ischemic attacks (TIAs). TIAs are mini-strokes.

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Infection
  • Damage to the carotid artery or nerves in the neck
  • High blood pressure or low blood pressure
  • Stroke

Things that may raise the risk of problems are:

  • Smoking
  • How much the carotid artery is blocked
  • Blockage of the carotid arteries on both sides of the neck
  • Long term diseases such as diabetes or obesity

What to Expect

Problems To Look Out For

Call your doctor if you have any new symptoms or:

  • Signs of infection, such as fever or chills
  • Redness, swelling, excess bleeding, or discharge at the incision site
  • Lasting nausea or vomiting
  • Pain that you cannot control with the medicines given
  • Severe headaches, swelling in the neck, or extreme sweating
  • Cough, problems breathing, or chest or arm pain
  • Drooping facial muscles or weakness, lightheadedness, or fainting
  • Problems thinking, speaking, seeing, or moving

If you think you have an emergency, call for medical help right away.

Prior to Procedure

The surgical team may talk to you about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and if you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Whether you need a ride to and from surgery
  • Tests that will need to be done before surgery

Prior to Procedure

The surgical team may talk to you about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and if you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Whether you need a ride to and from surgery
  • Tests that will need to be done before surgery

Anesthesia

The doctor will give:

Description of the Procedure

An incision will be made in the skin along the side of the neck. The incision will run from behind the ear to above the breastbone. Clamps will be placed above and below the plaque on the carotid artery. Sometimes, a temporary bypass tube is used. The tube will keep blood flowing around the area that is being worked 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 part of the carotid artery may need to be removed. In this case, an artificial graft or a piece of vein will be sewn in to replace it. The neck incision will be closed with stitches. A bandage will be placed over the site.

How Long Will It Take?

2 to 4 hours

Will It Hurt?

Pain and discomfort are common in the first week. Medicine and home care help.

Average Hospital Stay

The usual length of stay is 1 to 3 days. People may need to stay longer if there are problems.

Post-procedure Care

At the Hospital

During your stay, the hospital staff will take steps to lower your risk of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to lower your risk of infection, such as:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your incisions

At Home

Recovery may take up to 2 weeks. Physical activity may be limited during this time. Diet changes can help prevent a return of plaque buildup.

RESOURCES:

CANADIAN RESOURCES:

CANADIAN RESOURCES:

References

  • Baiu, I. and Stern, J.R. Carotid artery endarterectomy. JAMA, 2020; 324 (1): 110.
  • Carotid artery stenosis repair. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/carotid-artery-stenosis-repair.
  • Carotid endarterectomy. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/treatments/16849-carotid-endarterectomy.
  • Questions and answers about carotid endarterectomy. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/questions-and-answers-about-carotid-endarterectomy.
  • Stroke treatments. American Heart Association website. Available at: https://www.stroke.org/en/about-stroke/types-of-stroke#.

Contributors

  • Nicole Meregian, PA
Last Updated:
2022-11-01

(C) Copyright 2022 EBSCO Information Services

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.