This surgery is done to restore normal blood flow to the brain to prevent a stroke if you already have symptoms of reduced blood flow. Carotid endarterectomy also may be performed preventively if a diagnostic test such as carotid ultrasound shows significant blockage that is likely to trigger a stroke. Carotid endarterectomy is not a cure. Your arteries can become blocked again if your underlying condition, such as high blood cholesterol, is not controlled and causes new plaque buildup.
Carotid endarterectomy is done in a hospital. You may have general anesthesia and will not be awake or feel pain during the surgery. Your surgeon instead may decide to use local anesthesia to numb only the part of your body being worked on so that he or she can check your brain’s reaction to the decreased blood flow during surgery. You also will be given medicine to relax you during the surgery. Your vital signs will be monitored during surgery. You will lie on your back on an operating table with your head turned to one side. Your surgeon will make an incision, or cut, on your neck to expose the blocked section of the carotid artery. Your surgeon will cut into the affected artery and remove the plaque through this cut. A temporary flexible tube may be inserted so blood can flow around the blocked area as the plaque is cleared. After removing the plaque from your artery, the surgeon will close the artery and neck incisions with stitches.
After surgery, you will recover in the hospital for one to two days. Your neck may hurt for a few days, and you may find it hard to swallow. Your doctor may prescribe medicine to prevent clots and suggest steps to keep your carotid arteries healthy.
Carotid endarterectomy is fairly safe when performed by experienced surgeons. However, serious complications such as clotting, stroke, or death may occur. Taking anticlotting medicines before and after surgery can reduce this risk. Other complications may include a reaction to anesthesia, short-term nerve injury that causes temporary numbness in your face or tongue, bleeding, infection, high blood pressure, heart attack, and seizure. The risk of complications is higher in women, older people, those with certain conditions such as chronic kidney disease or diabetes, and those with other serious medical conditions.
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The National Heart, Lung, and Blood Institute (NHLBI) leads or sponsors many studies aimed at preventing, diagnosing, and treating heart, lung, blood, and sleep disorders.