What is carotid artery endarterectomy?

When stroke occurs because of a blockage in a carotid artery, surgery to remove the obstruction reduces the likelihood of a recurrence. This surgical procedure, called carotid endarterectomy, is often the best treatment after a transient ischemic attack (TIA) or minor ischemic stroke that results from a significant narrowing (at least 70 percent) of a carotid artery, and it may also be appropriate for some people with less complete obstruction.

If you are a candidate for carotid endarterectomy, you and your doctor must weigh the complex risks—which include the chance of a heart attack or even another stroke—against the potential benefits of the procedure in your case.

The standard method of treating disease in the carotid artery is via an operation called carotid endarterectomy. During this procedure, which is performed under general anesthesia, surgeons clamp one of the diseased carotid arteries to stop blood from flowing through it, make an incision into the blocked section of the artery, and remove the plaque deposit. The surgeon may also widen the artery using a patch from a vein in the leg or a synthetic material. The artery is then sewn closed and unclamped. Patients usually go home the following day.

Carotid endarterectomy is a highly effective surgical procedure that has been the standard in stroke prevention for decades. During a carotid endarterectomy, a vascular surgeon makes an incision in the patient's neck directly at the point of the blockage of the carotid artery. The surgeon then removes the plaque (a fatty substance) that is forming the blockage. This procedure is performed in the operating room and patients are placed under anesthesia.

Carotid endarterectomy is indicated for a wide range of patients, but research indicates that it seems to be particularly effective for those who are over age 69.

In a carotid endarterectomy (CEA), atherosclerotic plaque that has built up on the inside of the carotid artery wall is surgically removed. (The main supply of blood to the brain is carried by the carotid arteries.)

An incision is made on the side of the neck where the affected carotid artery is located. The carotid artery extends upward through the neck carrying oxygen-rich blood to the brain. Under direct visualization, the artery is opened and the plaque removed. The artery is sutured back together, restoring normal blood flow to the brain. This procedure may be performed while a patient remains awake under local anesthesia or while the patient is asleep under general anesthesia.

The name carotid endarterectomy is a mouthful, but it is a relatively simple surgery that removes plaque in one of your carotid arteries (the main arteries in your neck that supply blood to the brain). In this case, the chest is not opened—the surgeon exposes the artery through a small incision in the neck. After removing the plaque, the surgeon may use a patch made of skin or synthetic material to widen the artery. A carotid endarterectomy might be recommended if you have been experiencing stroke-like events called transient ischemic attacks (TIAs), caused by blockages in tiny arteries in the brain. One or more TIAs are a sign of atherosclerosis, which may also be present in the carotid arteries. If plaque buildup is found there, this surgery is used to improve blood flow to the brain and help prevent a future stroke.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.