The carotid arteries carry blood to the brain. Plaque or fatty material that collect inside these arteries can affect blood flow, which can lead to stroke.
Carotid endarterectomy is the removal of plaque from the carotid artery. This is done by making an incision in the neck.
This surgery has a low risk of stroke or complications, and typically results in a quick recovery with little pain. In most cases, patients are under general anesthesia during surgery, while others are awake with local anesthesia to control the pain.
Before Carotid Endarterectomy
As with any surgical procedure, prior to carotid endarterectomy, your medical team will provide you with specific instructions for preparing for surgery:
- Don’t eat or drink after midnight on the night before the procedure. Ask your doctor whether you should continue to take any medications during this period.
- At the hospital, you will change into a hospital gown. An IV (intravenous) line will be started to provide you with fluids and medications.
During Carotid Endarterectomy
An incision is made in the skin over the carotid artery. The surgeon places clamps on the artery above and below the blockage, which temporarily stops blood flow.
The surgeon then makes an incision in the artery itself. A shunt may be used to preserve blood flow to the brain during the procedure. After the shunt is in place, the clamps are removed from the internal carotid artery.
The surgeon loosens plaque from the artery wall. The plaque is then removed, often in a single piece. The surgeon inspects the artery to confirm that all of the plaque has been removed.
He or she then closes the incision using either sutures or a patch. The surgeon may suture the incision closed, then the clamps are removed. Next, the skin incision is closed. A tube may be put in place to keep fluids from collecting around the area.
Recovering After Carotid Endarterectomy
You will receive medications to control pain if you need them. You will also be monitored, and you may have certain tests. If you have a drain in place, it will be removed before you leave the hospital. An adult should drive you home.
When you return home, take it easy, but get back to your normal routine as much as possible. You can expect to be back to your usual activities in about a week. Meanwhile:
- Take medications as prescribed.
- Keep the neck incision site clean and dry.
- Avoid lifting anything over 10 pounds for about a week.
- Do not drive until your doctor clears you to do so.
- Shave carefully around your incision.
If you have stroke symptoms, call 911.
Call your doctor if:
- You have problems at the incision or puncture site, such as swelling, redness, warmth, or increasing pain.
- You experience mental confusion or headaches.
Follow-Up After Carotid Endarterectomy
After the procedure, you will have a follow-up exam and tests. Ultrasound or other imaging tests may be needed regularly from now on.
Restenosis (re-narrowing of the artery) is uncommon, but it does sometimes occur. If so, you may need to have another procedure.
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