Carotid Endarterectomy Surgery

For more information, please visit our Cerebrovascular, Stroke and Endovascular Program site

What is it?

The carotid arteries are a pair of arteries that start from or near the aorta and travel in the neck towards the head, where they supply blood to a large portion of the brain. Over time, plaque can build up within one or both of the carotid arteries, leading to stenosis, or narrowing. These plaques can lead to stroke. Carotid endarterectomy is a surgery designed to remove this plaque build-up from within the carotid artery.

What is its goal?

The goal of an endarterectomy is to reduce a patient’s risk of stroke.

How is it done?

A carotid endarterectomy is performed in the operating room. It is usually performed with the patient asleep, but it can be performed with the patient awake (local anesthetics are first given so that the patient won’t feel any pain). An incision in the neck and the carotid artery is exposed. Clamps are placed to temporarily stop blood from traveling through the artery. An incision is made in the artery and the plaque is removed. The artery is closed, the clamps removed, and finally the skin is sutured.

What are the risks?

As with any disease of the brain or its blood vessels, the decision to undergo treatment for carotid stenosis requires a careful consideration of possible benefits versus risks. The risks of carotid endarterectomy include bleeding or bruising, nerve injury that may affect speech, tongue, or shoulder movement, blood vessel damage or blockage, and stroke. Additionally, a plaque requiring further treatment may return over time. There is no easy formula that can allow physicians and their patients to reach a decision on the best course of therapy—all therapeutic decisions must be made on a case-by-case basis.

What is the success rate?

In carotid endarterectomy surgery, success is measured by a decreased rate of stroke. In carefully selected patients, there is a significantly reduced stroke rate compared to those who do not undergo the surgery. Depending on how blocked the artery is at the time of surgery, this risk reduction can be as high as 16%.

How long will I stay in the hospital?

Most patients are able to return home in one to two days following surgery.

What is special about the way we deliver this treatment?

The University of Rochester Department of Neurosurgery includes surgeons specially trained to provide full care for all diseases involving the blood vessels of the brain. They are members of a multidisciplinary team that also includes Stroke Neurologists and Neuroradiologists. The team meets regularly to discuss all aspects of patients with complex problems.