Key Points

• Carotid endarterectomy (CEA) is surgery to remove plaque from the carotid arteries. These arteries supply oxygen-rich blood to your brain.
• CEA is used to prevent stroke in people who have carotid artery disease. Carotid artery disease occurs when plaque builds up in the carotid arteries. Over time, plaque hardens and narrows the arteries. This limits or blocks the flow of oxygen-rich blood to your brain, which can lead to a stroke.
• CEA is most helpful for people who have carotid artery disease and one or more of the following:
  • A prior stroke.
  • A prior transient ischemic attack (TIA), or "mini-stroke." During a mini-stroke, you may have some or all of the symptoms of stroke. However, the symptoms usually go away on their own within 24 hours.
  • Severely blocked carotid arteries (even if you don't have stroke symptoms).
• Other treatments, such as carotid angioplasty and medicines, also are used to treat carotid artery disease.
• Your doctor will talk to you about how to prepare for CEA. Before the procedure, you may have one or more tests to examine your carotid arteries. These tests can show whether your arteries are narrowed or blocked, and how severe your condition is.
• CEA is done in a hospital. The surgery usually takes about 2 hours. You will have anesthesia during the surgery so you don't feel any pain.
• During CEA, your surgeon will make an incision (cut) in your neck to expose the blocked section of the carotid artery. He or she will then make a cut in the artery and remove the plaque inside. Finally, your surgeon will close the artery with stitches and stop any bleeding. He or she will then close the incision in your neck.
• After CEA, you may stay in the hospital for 1 to 2 days. This allows your doctor to watch for any signs of complications. Many people are able to go back to their normal activities within about 3 weeks after having CEA.
• After CEA, it's important to get ongoing care and treatment. Discuss your treatment needs with your doctor. Ask him or her when to schedule followup visits.
• As part of your long-term treatment, you can take steps to keep your carotid arteries healthy. For example, don't smoke. Treat other conditions, such as high blood pressure and high blood cholesterol.
• Following your treatment plan can help lower your chance of needing a second CEA; it also can reduce your risk of stroke.
• Serious complications from CEA are uncommon, but they do occur. For example, there's a small risk of having a stroke during or after the surgery. There's also a small risk of brain damage, heart attack, or death. Talk to your doctor about the risks of CEA. He or she can help you decide whether the surgery is right for you.