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Endarterectomy

Authors:
  • Ricker Polsdorfer MD
Publication Type:

Procedure

Endarterectomy

Definition

Endarterectomy is a surgery to remove build-up in blood vessels. It is most often done in:

  • Carotid arteries in the neck that supply blood to the brain
  • Aorta—this is the largest artery in body and it affects blood flow to entire body
  • Iliac and femoral arteries in the legs
  • Renal arteries that bring blood to the kidneys

Reasons for Procedure

Plaque is a build-up on the lining of blood vessels. It can cause the artery to narrow and harden. This build-up and damage to the blood vessel is known as atherosclerosis. The plaque can slow and even stop blood flow. It can lead to stroke, weakness, cramps, and aching.

Endarterectomy is done to remove the build-up. It should help with blood flow. The symptoms should also get better.

Bilateral Carotid Artery Atherosclerosis.

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Possible Complications

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

  • Bleeding
  • Stroke—the highest risk is with the carotid arteries
  • Blood clots
  • Bad reaction to the anesthesia
  • Infection

Other things that can raise the risk of problems are:

  • Smoking
  • Drinking alcohol
  • Chronic health problems such as diabetes or obesity

Your risk of problems may also be higher if there is plaque build-up in other areas.

What to Expect

Problems To Look Out For

Call your doctor if you have:

  • Signs of infection, such as fever and chills
  • Redness, swelling, more pain, a lot of bleeding, or any discharge from the incision site
  • Nausea or vomiting
  • Pain that is not helped with the medicine you were given
  • Constipation, diarrhea, or problems passing urine (pee)
  • Lightheadedness
  • Severe headaches
  • Problems with speech or vision
  • Cough, shortness of breath, or chest pain

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

Prior to Procedure

An exam will be done to make sure you are healthy enough for surgery. Images of the arteries will be reviewed.

Let the doctor know about any medicine you are taking. Some medicine may need to be stopped up to 1 week before the procedure.

  • Avoid food and drink after midnight the night before.
  • Arrange for a ride home from the hospital.

Prior to Procedure

An exam will be done to make sure you are healthy enough for surgery. Images of the arteries will be reviewed.

Let the doctor know about any medicine you are taking. Some medicine may need to be stopped up to 1 week before the procedure.

  • Avoid food and drink after midnight the night before.
  • Arrange for a ride home from the hospital.

Anesthesia

Anesthesia will be based on where the artery is. Options include:

  • General anesthesia—blocks any pain and keeps you asleep
  • Local anesthesia—numbs an area but you will be awake

Description of the Procedure

Incisions will be made over the artery. Blood flow can be stopped to some places until the work is done. Blood flow through the neck cannot be stopped. A new pathway will be made to let blood flow while the artery is cleared out. A small tube or a piece of a vein may be used to make the new path.

A tube will be inserted into the artery. A sharp blade will trim the plaque away from the wall. A device can also help catch and pull out loose plaque. The artery and skin will then be closed with sutures or staples.

How Long Will It Take?

It depends on how much plaque needs to be removed and where the problem is. It often takes several hours.

How Much Will It Hurt?

There will be some pain at the incisions. Medicine can help ease pain.

Average Hospital Stay

You may be able to leave the same day or you may need to stay 1 day to 1 week. The stay may be longer if there are problems.

Post-procedure Care

At the Hospital

Care after the procedure may include:

  • Watching for problems such as bleeding, clotting, or infection
  • Managing pain

Hospital staff will take steps to lower the risk of infection such as:

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

Steps you can take to lower the risk of infection include:

  • Wash your hands often. Remind visitors and care team to do the same.
  • Remind your care team to wear gloves or masks.
  • Do not let others touch your wounds.

At Home

Plaque can build up again. Medicine and a healthy diet may stop or slow more plaque growth.

RESOURCES:

CANADIAN RESOURCES:

CANADIAN RESOURCES:

References

  • Carotid artery stenosis repair. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/carotid-artery-stenosis-repair.
  • Carotid endarterectomy. Society for Vascular Surgery website. Available at: https://vascular.org/patients-and-referring-physicians/conditions/carotid-endarterectomy.
  • Endarterectomy. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/treatments/17312-pad-endarterectomy.

Contributors

  • Michael J. Fucci, DO, FACC
Last Updated:
2022-11-01

(C) Copyright 2023 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.