Carotid endarterectomy

What is carotid endarterectomy?

The carotid arteries are considered one of the largest arterial systems in the human body. They are located on the sides of the neck and their function is to carry oxygen-rich blood from the heart muscle to the brain. The carotid arteries often suffer the negative consequences of atherosclerosis. Atherosclerosis is characterized by the accumulation of plaques in the blood vessels. The plaques, which are formed from substances such as fat, cholesterol and calcium, can lead to occlusion of the arteries and can therefore carry a risk of thrombosis, embolism and stroke. Carotid endarterectomy is a surgical operation aimed at removing blockages in the carotid arteries.

The carotid arteries are considered one of the largest arterial systems in the human body.

Why is it performed?

Carotid endarterectomy should be performed in the following cases:

  • When carotid vein occlusion is 60%.
  • When the carotid veins are narrowed by 50% and the patient has suffered a stroke.

What does it consist of?

The procedure lasts approximately two hours and is performed under general or local anesthesia. The surgeon makes an incision near the carotid artery to be treated and prevents blood from passing through it to work comfortably. The plaque blocking the carotid artery is removed through a second incision; the incisions are sutured or closed with a tissue patch. Finally, blood flow within the carotid artery is restored.

Preparing for carotid endarterectomy

Before surgery can be performed, routine tests must be performed to study the location of the carotid artery blockage or occlusions. The following is a list of these diagnostic tests:

  • Carotid ultrasound: an ultrasound probe resting on the neck projects images depicting the morphology of the carotid arteries onto a screen;
  • Carotid angiography: a contrast liquid is injected into the carotid arteries that will be visible by X-ray observation;
  • Magnetic resonance angiography: similar to carotid angiography, a contrast liquid is used to observe the carotid arteries, but using magnetic resonance imaging.
  • Angio-CT: this is a CT scan that, as in the two previous cases, uses a contrast liquid to detect carotid artery disorders.
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Postoperative recovery

It is normal to experience pain in the neck near the carotid artery and difficulty eating hard foods for a couple of days. After the operation, the patient will remain hospitalized for approximately 2 days. The patient can return to work after about 3 weeks on average. If the stitches in the neck are not resorbable, your doctor will advise you on the best time to remove them.

Alternative treatments

If the carotid artery obstruction is in a difficult to access location, or if the patient is in poor general health, carotid endarterectomy may be contraindicated. In these cases, there are other therapeutic techniques, such as carotid angioplasty. For more information, you can consult a Vascular Surgeon.