Carotid stenosis is a condition where plaque buildup in the carotid arteries of your neck reduces blood flow to your brain. Carotid endarterectomy is a procedure used to reduce the risk of future stroke from this plaque. During a carotid endarterectomy, your surgeon removes the plaque from your carotid arteries to restore proper blood flow.
Why Choose The Ohio State University Medical Center?
Vascular surgeons at Ohio State’s Medical Center have expertise in diagnosing and treating carotid stenosis. They are experts at treating carotid artery stenosis with both carotid endarterectomy (surgery) and carotid stenting, and understand the advantages and disadvantages of each approach. Because of this, they can offer an unbiased opinion based strictly on the available research on which treatment method is best in your particular case.
What Is Carotid Endarterectomy?
There are two carotid arteries in your neck, each supplying blood to one side of your brain. Carotid artery disease occurs when these arteries become narrowed or blocked, reducing blood flow. Reduced blood flow to the brain can lead to a stroke.
Carotid endarterectomy is a procedure used to treat carotid artery disease. During this procedure, your surgeon makes an incision in your neck in order to remove the plaque from the inner lining of your carotid arteries, restoring proper blood flow to your brain.
Why Have Carotid Endarterectomy?
Carotid artery disease is a serious condition. As plaque builds up, your risk of developing blood clots increases. A blood clot can travel through your bloodstream and lodge in your brain. Plaque buildup and blood clots result in reduced blood flow to your brain, and can cause stroke. Depending on how much of your brain is affected, stroke can result in permanent brain damage, paralysis or even death.
When a blockage affects only a small artery in the brain, it may cause a transient ischemic attack (TIA), also known as a mini-stroke. TIAs are often a warning sign of an impending stroke. Symptoms of TIA are the same as those associated with a stroke; however, with a TIA, symptoms will only last from a few minutes to a couple of hours. If you experience any of the following symptoms, seek medical care immediately:
- Difficulty swallowing
- Difficulty writing or reading
- Lack of coordination and balance
- Loss of vision
- Muscle weakness, numbness or tingling (usually only on one side of the body)
- Trouble speaking or understanding others
A carotid endarterectomy is recommended for individuals with severe blockage in their neck arteries who are at high risk of having a stroke. It is a safe and long-lasting treatment that restores proper blood flow to your brain.
What to Expect During Carotid Endarterectomy
Preparing for Your Procedure
Prior to your carotid endarterectomy, you meet with your physician to discuss your medical history, medications you take and any questions you have. Tests before an endarterectomy may include:
- Carotid angiogram – An X-ray of the carotid arteries to identify blockage; it is performed by inserting a tube into an artery in the leg and injecting a contrast dye into the artery.
- MRA (magnetic resonance arteriography) – A noninvasive imaging procedure that uses large magnets, radiofrequencies and a computer to evaluate blood flow through arteries.
- Carotid duplex – A painless ultrasound procedure that shows how well blood is flowing through the carotid arteries.
Your doctor may advise you not to eat or drink anything for several hours prior to your procedure.
During Your Procedure
You are given medication before your carotid endarterectomy to put you to sleep. Your neck is cleaned and shaved as a precaution to prevent infection.
Your physician makes an incision in your neck and opens your blocked carotid artery. The plaque in the artery is removed, and your artery and incision are closed. The procedure takes about two hours.
After Your Procedure
After a carotid endarterectomy, you spend one or two nights in the hospital. Your neck may hurt and you may have difficulty swallowing.
After you return home, your physician will likely recommend you refrain from heavy lifting and vigorous activity for a week.
Contact your physician immediately if you experience severe headaches, swelling in your neck or any change in brain function, such as difficulty speaking or performing common functions.