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What is the Carotid Endarterectomy Procedure For?

written by: Emma Lloyd • edited by: Leigh A. Zaykoski • updated: 8/31/2009

Carotid endarterectomy is performed on patients whose arteries have been damaged by a condition called atherosclerosis.

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    Atherosclerosis and Stroke

    The carotid arteries, which are located on either side of the neck, transport blood to and from the brain. These all-important arteries can become partially or fully blocked due to the formation of fatty plaques within the arteries. Plaques build up in the arteries with age, causing them to become narrower and inflexible. This hardening of the arteries is called atherosclerosis.

    Blockage of a carotid artery can result in a stroke, due to the interruption of the brain’s blood supply.

    Some people who are at risk of stroke due to atherosclerosis may have what are called transient ischemic attacks, also known as mini-strokes. These occur when a small artery in the brain becomes blocked due to plaque formation. One or more mini-strokes is often a sign that a larger and more dangerous stroke may occur in the near future.

    When someone suffers from one or more mini-strokes, the carotid endarterectomy procedure may be carried out to remove plaques from the carotid arteries. Removal of plaques helps reduce the risk of a major stroke occurring, and should also prevent the occurrence of further mini-strokes.

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    About the Carotid Endarterectomy Procedure

    Prior to the procedure, various diagnostic tests are used to determine the location and extent of the arterial plaques which need to be removed. These tests may include ultrasound, arteriography, or CT scan.

    During the procedure, general or local anesthetic is used depending on circumstances and risk factors. Once the patient has been anesthetized, the surgeon makes an incision in neck to expose the blocked carotid artery. The artery is clamped near the site of blockage to prevent blood flow. Next, the surgeon makes an incision in the artery itself, so that the blockage can be removed. Once the blockage is removed, the surgeon may repair the artery with a vein graft. If a graft is used, the tissue is usually taken from a vein in the patient’s leg.

    The procedure usually takes around two hours to complete. Once surgery is over, a hospital stay of one or two days is usual. For most people, a recovery period of several weeks is needed before normal activities can be resumed.

    People with certain conditions are at increased risk of complications during the procedure. These conditions include cancer, uncontrolled high blood pressure, unstable angina, congestive heart failure, diabetes, and previous stroke or heart attack. Cigarette smokers are also at increased risk of suffering complications. Possible complications include stroke, artery re-blockage, and temporary nerve injury.

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    References

    Michael E. Debakey Department of Surgery at Baylor College of Medicine: Carotid Endarterectomy

    Society for Vascular Surgery Vascular Web: Carotid Endarterectomy

    What is Carotid Endarterectomy? Published by the American Heart Association and the American Stroke Association.