Carotid endarterectomy may be performed to treat a blockage or narrowing of the carotid arteries and improve blood supply to the brain. It has been shown to be effective for preventing stroke for patients with carotid artery disease.
What is carotid endarterectomy?
Carotid endarterectomy is a procedure that requires your doctor to make an incision on the side of the neck of the affected carotid artery, and under direct visualization, the artery is opened and the atherosclerotic plaque removed. This procedure may be performed while you are awake under local anesthesia, or under general anesthesia.
How to Prepare
Your surgeon will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the procedure.
You will need to fast prior to the procedure. Your doctor will notify you how long to fast, usually overnight.
Notify your doctor of all medications (prescription, over-the-counter or herbal supplements) you are taking; if you are pregnant or suspect that you may be pregnant; if you are allergic to or sensitive to medications, local anesthesia, or latex; or if you have a pacemaker.
If you smoke, you should stop smoking as soon as possible prior to the procedure. This may improve your chances for a successful recovery from surgery and benefit your overall health status, as smoking increases clot formation in the blood.
Your doctor may request a blood test to determine how long it takes your blood to clot.
What to Expect During the Procedure
During a minimally invasive procedure the vascular surgeon threads a catheter through the femoral artery, up through the aorta, and inflates a balloon to dilate the carotid artery. A device is used to protect the brain from embolization of plaque material.
In a traditional procedure you will be positioned on the operating table, lying on your back, with your head raised slightly and turned away from the side to be operated on.
Under local anesthesia, you will be sleepy and will not feel the area being operated on. You will receive a sedative medication in your IV before the procedure to help you relax. You doctor will make an incision down the side of the neck over the diseased artery, followed by an incision into the artery. A shunt may be used to divert blood flow around the surgical area and maintain blood flow to the brain during the surgery. Once the artery is clear the incision in the artery and neck will then be closed.
After the Procedure
When the procedure is completed you will be moved to recovery and then admitted for observation and to manage any pain associated with the procedure. If a drainage tube was placed in the incision during the procedure, it most likely will be removed the next morning and you should be able to go home within one to two days.
Your doctor may schedule you for follow-up duplex ultrasound procedures to monitor the carotid arteries in your neck for a period of time.