Carotid Endarterectomy Surgery

Carotid Endarterectomy is one of the most common operations performed by vascular surgeons. Its purpose is to prevent a stroke (see above) by removing atherosclerotic plaque from the carotid artery. It can not reverse the effects of a stroke that has already occurred. It can be performed under local anesthetic or general anaesthetic. There is no convincing evidence that either general or local anaesthetic is safer and the choice is usually your preference or your surgeon's. The surgery involves an incision in the neck over the course of the carotid artery. The artery is clamped (i.e. temporarily blocked by a surgical instrument) above and below the narrowing and then opened. Your surgeon may choose to use a small plastic tube (a "shunt") to maintain flow in the carotid artery while it is the clamped. Your surgeon will then carefully remove the diseased plaque from your carotid artery leaving behind a smooth surface. The opening in the artery is then usually closed with a patch. A variety of materials can be used for the patch (e.g. a spare segment of one or your own veins or Dacron - a polyester type material). The purpose of the patch is to widen the artery to minimize the chance of it re-narrowing in the future. The surgery usually takes about 2 hours. The neck incision is not usually very painful and most patients only need to stay in hospital 1 or 2 nights after their surgery. You may have small plastic tube coming out of your neck (a drain) for the first 24 hours after surgery. This is designed to try to detect and manage any bleeding that may occur after the surgery. If present it is usually removed the morning after the surgery. Your surgeon will probably want to see you 4 to 6 weeks after your surgery to check on you. They may wish to obtain an ultrasound scan to check on your carotid artery at this time but due to the low rate of complications after carotid surgery long term follow up is not justified.

Potential Complications of Carotid Surgery

All surgery carries the risk of complications. Although carotid endarterectomy is a major operation it is generally very well tolerated and the serious post-operative complications are uncommon. Some of the most serious and common complications are listed below. This list is not exhaustive and you should consult your surgeon regarding any specific concerns you may have.

Discharge Information after Carotid Surgery

Next: Carotid Stenting.