Carotid Endarterectomy

Surgical procedure to remove plaque from the carotid artery

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Surgical procedure of carotid endarterectomy

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Carotid endarterectomy is a surgical procedure used to reduce the risk of stroke by correcting stenosis (narrowing) in the common carotid artery or internal carotid artery.

Indications

Carotid endarterectomy is primarily indicated for patients with significant carotid artery stenosis, which is often due to atherosclerosis. The procedure is recommended for patients who have experienced transient ischemic attacks (TIAs) or minor strokes and have a stenosis of 70% or greater. It may also be considered for asymptomatic patients with severe stenosis.

Procedure

The procedure is typically performed under general anesthesia, although local anesthesia may be used in some cases. The surgeon makes an incision along the side of the neck to expose the affected carotid artery. The artery is then clamped, and an incision is made into the artery to remove the atherosclerotic plaque. After the plaque is removed, the artery is closed with sutures, and blood flow is restored.

Risks and Complications

As with any surgical procedure, carotid endarterectomy carries risks, including:

• Stroke
• Myocardial infarction
• Cranial nerve injury
• Infection
• Bleeding

The risk of stroke during or immediately after the procedure is approximately 2-3% for asymptomatic patients and 5-7% for symptomatic patients.

Recovery

Patients typically stay in the hospital for 1-2 days following the procedure. Recovery involves monitoring for any signs of complications, such as stroke or cranial nerve injury. Most patients can return to normal activities within a few weeks.

Alternatives

An alternative to carotid endarterectomy is carotid artery stenting, a less invasive procedure that involves placing a stent to widen the artery. This option may be suitable for patients who are at high risk for surgical complications.

Prognosis

Carotid endarterectomy has been shown to significantly reduce the risk of stroke in patients with severe carotid artery stenosis. Long-term outcomes are generally favorable, with a reduction in the incidence of stroke and other cardiovascular events.

Also see

• Atherosclerosis
• Stroke
• Transient ischemic attack
• Carotid artery stenting
• Vascular surgery