Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery
Carotid artery surgery is a procedure to treat carotid artery disease.
The carotid artery brings needed blood to your brain and face. You have one of these arteries on each side of your neck. Blood flow in this artery can become partly or totally blocked by fatty material called plaque. This can reduce the blood supply to your brain and cause a transient ischemic attack (TIA) or stroke.
Carotid artery surgery is done to restore proper blood flow to the brain. There are two procedures to treat a carotid artery that has plaque buildup in it. This article focuses on a surgery called carotid endarterectomy. The other method is called angioplasty with stent placement.
During carotid endarterectomy:
The surgery takes about 2 hours. After the procedure, your surgeon may do a test to confirm that the artery has been opened.
This procedure is done if your health care provider has found narrowing or a blockage in your carotid artery. Your provider will have done one or more tests to see how much the carotid artery is blocked.
Surgery to remove the buildup in your carotid artery may be done if the artery is narrowed by more than 70%.
If you have had a stroke or temporary brain injury, your provider will consider whether treating your blocked artery with surgery is safe for you.
Other treatment options your provider will discuss with you are:
Carotid angioplasty and stenting is likely to be used when carotid endarterectomy would not be safe.
Risks of anesthesia are:
Risks of carotid surgery are:
Your provider will do a thorough physical exam and order several medical tests.
Tell your provider what medicines you are taking, even medicines, supplements, or herbs you bought without a prescription.
During the 2 weeks before your surgery:
Follow instructions on when to stop eating and drinking before surgery.
On the day of your surgery:
You may have a drain in your neck that goes into your incision. It will drain fluid that builds up in the area. It will be removed within a day.
After surgery, your surgeon may want you to stay in the hospital overnight so that nurses can watch you for any signs of bleeding, stroke, or poor blood flow to your brain. You may be able to go home the same day if your operation is done early in the day and you are doing well.
Follow instructions on how to take care of yourself at home.
Carotid artery surgery may help lower your chance of having a stroke. But you will need to make lifestyle changes to help prevent plaque buildup, blood clots, and other problems in your carotid arteries over time. You may need to change your diet and start an exercise program, if your provider tells you exercise is safe for you. It is also important to stop smoking.
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Brott TG, Howard G, Roubin GS, et al. Long-term results of stenting versus endarterectomy for carotid-artery stenosis. N Engl J Med. 2016;374(11):1021-1031. PMID: 26890472 pubmed.ncbi.nlm.nih.gov/26890472/.
Perler BA. Carotid endarterectomy. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. 14th ed. Philadelphia, PA: Elsevier; 2023:1025-1031.
Perler BA. Carotid endarterectomy. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 93.BACK TO TOP
Review Date: 4/16/2023
Reviewed By: Mary C. Mancini, MD, PhD, Cardiothoracic Surgeon, Shreveport, LA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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