Carotid artery surgery

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	Arterial plaque build-up	Atherosclerosis of internal carotid artery
Carotid stenosis, X-ray of the left artery	Carotid stenosis, X-ray of the right artery

Carotid artery surgery is a procedure to restore proper blood flow to the brain.

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. Such a blockage can reduce the blood supply to your brain and may cause a stroke.

There are two invasive ways to treat a carotid artery that has plaque buildup in it. This article focuses on a surgery called endarterectomy.

For more information on the other procedure, see: Angioplasty with stent placement.

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Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery

During carotid endarterectomy:

• You will probably receive general anesthesia. This will make you unconscious and unable to feel pain. Some hospitals may use local anesthesia instead. Only the part of your body being worked on will be made numb with medicine so that you will not feel pain. You will be given a medicine to help you relax.
• You will lie on your back on a padded operating table with your head turned to one side. The side that will face up is the side your blocked carotid artery is on.
• Your surgeon will make a surgical cut on your neck over your carotid artery. Your surgeon will put a catheter (a flexible tube) in place. Blood will flow through the catheter around the blocked area during surgery.
• Then your surgeon will open your carotid artery. The surgeon will remove the plaque inside your artery.
• Your artery will be closed up with stitches after the plaque is removed. Blood will now flow through the artery to your brain.
• Your heart and brain activity will be monitored closely during your surgery.

There are several ways your doctor may know you have narrowing or blockage in your carotid artery. Two common ones are:

• You may have had symptoms of a stroke or a transient ischemic attack (TIA, also called a mini-stroke). Some of these symptoms are weakness, blurred vision, confusion, or slurred speech.
• You may not have any symptoms, but your doctor may find a problem during a physical exam. Your doctor may hear something called a bruit when using a stethoscope to listen to your blood flow. A bruit is an abnormal sound in your artery.