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Read MoreWhen plaque builds up in the carotid arteries, it can narrow or block blood flow to the brain, increasing the risk of stroke. Carotid endarterectomy is a proven surgical option that removes this plaque, restores healthy circulation and helps prevent future neurological events.
What Is a Carotid Endarterectomy?
Carotid endarterectomy is a surgery that removes fatty plaque deposits from the inner lining of the carotid arteries, the major blood vessels in the neck that supply oxygen-rich blood to the brain. By gently opening the artery and extracting the atherosclerotic buildup, the surgeon restores a smoother, wider channel for blood flow. This procedure helps reduce turbulent flow and the risk of clot formation, both of which can lead to transient ischemic attacks (TIAs) or stroke.
It is recommended for patients who have significant carotid artery narrowing, typically 50 percent or greater, in either symptomatic individuals (those who have experienced TIAs or minor strokes) or select asymptomatic patients with high-grade stenosis. By removing the blockage, carotid endarterectomy can lower the risk of a future neurological event and improve your overall circulation.
How Carotid Endarterectomy Works
Your surgeon will start by making a careful incision along the side of the neck to expose the affected carotid artery. Once the artery is visible, it is temporarily clamped above and below the plaque buildup to halt blood flow. The surgeon then makes a precise opening in the artery wall and gently peels away the atherosclerotic plaque, restoring a clear channel for blood to pass through.
After removing the plaque, many surgeons reinforce the artery by sewing in a patch, either harvested from the patient’s vein or made from a synthetic material. This patch widens the artery at the incision site and prevents narrowing over time.
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Types of Carotid Endarterectomy
Standard Carotid Endarterectomy with Primary Closure
In this traditional approach, the surgeon opens the carotid artery, removes the plaque and closes the incision with sutures alone, restoring normal blood flow without adding additional materials.
Carotid Endarterectomy with Patch Angioplasty
After plaque removal, a vein- or synthetic-material patch is sewn into the artery wall to widen the vessel and reduce the risk of future narrowing, improving long-term artery patency.
Eversion Carotid Endarterectomy
The surgeon cuts the artery near its origin, turns the vessel inside out to strip away plaque and reattaches the artery end-to-end, often eliminating the need for a patch.
What To Expect During a Carotid Endarterectomy
Before surgery, your care team reviews your medical history, medications and imaging results. You may need to fast the night before and pause certain medicines. On surgery day, hospital staff will prepare you and answer any last-minute questions.
Under general anesthesia, your surgeon makes a small neck incision to access the carotid artery and remove plaque. The procedure typically takes one to two hours with continuous monitoring for your safety. The team monitors your vital signs and cerebral function closely throughout to ensure your safety and comfort.
After surgery, you’ll recover in the hospital for one or two days. Nurses will monitor your incision, check blood flow and assess your neurological status. You’ll get instructions on resuming medications, activity and blood pressure management before going home. Recovery guidance focuses on healthy habits and knowing when to contact your care team.
