A carotid endarterectomy is a surgical procedure with goal to prevent stroke. It is a durable procedure but not a cure; though rare, blockage can accumulate again.
Why It’s Done
Your vascular surgeon may recommend you have a carotid endarterectomy if you have:
A moderate (50-79%) blockage of a carotid artery and are experiencing symptoms such as stroke, mini-stroke or TIA (transient ischemic attack).
A severe (75-80% or more) blockage even if you have no symptoms.
Stroke occurs in 2–3% of patients with no pre-procedure symptoms; in 5–7% of patients with pre-procedure symptoms such as stroke, mini-stroke or TIA (transient ischemic attack). After the operation you will be asked to move your arms and legs and be examined by nurses and doctors to make sure that you have not had any new stroke symptoms.
Nerve damage, affecting your voice box, tongue, lower lip on side of surgery or back.
What Can I Expect After Treatment?
Expect to be in the hospital 1–2 days, longer if complications develop, in which case a stay at a rehabilitation facility may be needed.
You will have a sore throat and the skin around the incision on your neck will be numb. This improves over time.
You will see your vascular surgeon and have a carotid ultrasound to look at the artery. This will be done once or twice a year to make sure the plaque has not accumulated again.
You may wish to eat smooth, soft foods like soup and yogurt for a while before returning to your normal diet.
Driving is usually permitted once pain medicine is stopped and you can easily turn your head to check your surroundings on the road and safely merge with traffic.
A carotid endarterectomy is performed in a sterile surgical suite or standard operating room. You may go home the same day or stay 1–2 nights after the procedure depending on your medical condition.
The procedure is done under local anesthetic or general anesthesia. An incision is created at the front of your neck.
After removing the plaque from the artery, the artery is repaired by stitching in a natural graft (formed from a piece of vein from elsewhere in your body), biological material (typically bovine source) or a woven patch.
How to Prepare
Discuss your condition with family members or other individuals you have designated to participate in medical decisions.
Ask your vascular surgeon whether to continue or modify scheduled medications.