Carotid Endarterectomy

Peripheral arterial disease can affect many arteries throughout your body. Sometimes atherosclerotic plaque builds up in the arteries in the neck, the carotid arteries, that supply blood to the brain. If this blockage is severe, it is a major reason for a stroke to occur.

Here’s more about how carotid endarterectomy works and how to find out whether you’re an ideal candidate for this procedure.

What Is Carotid Endarterectomy?

Carotid endarterectomy is surgery to remove the plaque that clogs your carotid arteries. This can improve blood flow in the arteries and reduce your risk for stroke.

This surgery is recommended for people who have had a mini-stroke (also known as a TIA) and have blockage greater than 50%. It is also recommended when the blockage is over 70% in order to prevent a stroke. Your doctor can talk to you in more detail about whether the carotid endarterectomy procedure is ideal for you based on your condition.

What Happens During a Carotid Endarterectomy Procedure?

Carotid endarterectomy is performed under general anesthesia. First, your surgeon will make a small incision along the side of your neck at the site of artery blockage. Then, your surgeon will open your artery and remove the plaque deposits causing the blockage. Shunts or tubes may be used to temporarily reroute blood flow to the brain while the area is being worked on.

Next, your surgeon will close your cleaned out artery using stitches or a patch, after which normal blood flow will be restored. 

What Are the Risks Associated With Carotid Endarterectomy?

Carotid endarterectomy comes with risks like any other surgery or medical procedure.

There can be bleeding, but blood transfusion is a rare occurrence for this operation.

There is a risk of stroke from the operation, but it is much less than the risk of living with the blocked artery.

Heart attack and death can happen rarely and patients who need this operation will have their heart evaluated beforehand to minimize that risk.

If you are a candidate for carotid endarterectomy, your doctor can discuss all potential risks and complications with you before your surgery.

What Is Recovery Like After Carotid Endarterectomy?

Carotid endarterectomy usually requires a hospital stay of between one and two days. During that time, you will be monitored closely. You should be able to eat that evening. Many patients do not require any pain medication after surgery.

Before you go home, your surgeon will give you specific, detailed instructions on how to clean and care for your incision. Usually, you can shower the day after you go home. Your surgeon may also suggest avoiding strenuous activities for up to two weeks and may follow up with you during that time to check on your healing and recovery progress.

Who Are Ideal Candidates for Carotid Endarterectomy?

Ideal candidates for carotid endarterectomy have at least one severely narrowed carotid artery and are at high risk for stroke. Other potential carotid endarterectomy indications include a previous stroke or transient ischemic attack and moderate narrowing of one or both carotid arteries.

If you have carotid artery disease, your doctor will discuss all your available treatment options, including carotid endarterectomy. You can also consult with a doctor who specializes in cardiology and vascular conditions to learn more about whether this procedure is correct for you.


At the Center for Vascular Care at HCA, our team provides the resources you need to take control of your heart health. Contact us to make an appointment, learn more about your treatment options, and receive a personalized diagnosis from one of our specialists today.

Peripheral Artery Disease (PAD) Treatments

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Smoking Cessation Program

Quitting smoking can be a more important lifestyle change to reduce the risk of PAD complications and disease progression.

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Medication Therapy

Medications are used in a variety of ways depending on the progression of PAD. Medicines may be prescribed to prevent blood clots (blood thinners), control pain, lower blood pressure, and lower cholesterol. In patients with diabetes, medications to lower blood sugar may also be used.

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When artery-blocking blood clots form, a clot-dissolving drug is injected into the affected artery to break up the clot at its source.

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A catheter with a small balloon on its tip is inserted into the affected blood vessel. Once in place, the balloon is inflated, which presses the plaque buildup into the artery wall, allowing the artery to reopen and stretch, increasing blood flow. A mesh stent may be left in the artery to help it stay open. This procedure may also be called percutaneous transluminal angioplasty or just angioplasty.

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This surgery is performed under general anesthesia. A small incision is made on the neck where the artery blockage is located and shunts (tubes) may be used to temporarily reroute blood flow. The artery is opened along the plaque blockage, which is then removed. The artery is stitched closed, sometimes utilizing a patch, restoring normal blood flow.

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Bypass Surgery

This surgical technique works by creating a pathway around a narrowed or blocked artery by using a healthy blood vessel from another part of the body or sometimes a synthetic (manmade) vessel.

Patients Who Qualify for Our Services

  • Patients with cardiac risk factors or concern about PAD
  • Claudicants (patients with pain in legs while walking)
  • Diabetics
  • Tobacco users
  • Patients with lower extremity ulcers
  • Patients with coronary artery disease
  • Patients with high blood pressure
  • Family history of cardiovascular disease

Contact The Center for Vascular Care today to make an appointment to discuss your personalized diagnosis and treatment options with one of our specialists. Our team approach to PAD provides the resources you need to take control of your heart health.