Carotid Endarterectomy

About Carotid Endarterectomy

Carotid endarterectomy removes atherosclerotic plaque from the inner lining of the carotid artery in the neck, the main blood supply to much of the brain. The purpose is to lower the risk of stroke in people with significant narrowing of the carotid artery, especially those who have already had a transient ischemic attack or minor stroke on the same side. Through an incision along the side of the neck the artery is exposed and clamped, opened lengthwise, and the plaque is peeled away. The artery is then closed, often with a patch to widen it. Some surgeons use a temporary shunt to maintain blood flow to the brain during clamping, and the operation can be done under general or regional anesthesia, the latter allowing the neurological status of the patient to be monitored while awake. Major randomized trials in North America and Europe established the benefit of the operation for selected patients with symptomatic narrowing. Carotid artery stenting is a less invasive alternative in certain situations, and decisions are based on symptoms, degree of narrowing and overall health.