Carotid Endarterectomy
Carotid endarterectomy, also known as carotid artery surgery, is an open surgery to remove blood vessel blockage from the neck’s carotid artery. Since the carotid artery is a major blood vessel supplying blood to the brain, carotid endarterectomy surgery can help reduce the risk of stroke and improve blood flow. Learning how this procedure works can help ease your worries about your treatment options and may help you manage your condition.
What Is Carotid Endarterectomy?
Carotid endarterectomy (CEA) may be recommended to patients with blockage in their carotid arteries to help reduce the risk of stroke. Carotid arteries deliver nutrient-rich blood to the brain. However, they can be partly or totally blocked by plaque, which is composed of cholesterol, calcium and other substances in the blood. This blockage can reduce blood supply to the brain, leading to a transient ischemic attack (TIA) or stroke. CEA surgery is a carotid artery disease treatment that can help improve blood flow by removing plaque.
How Long Is Carotid Endarterectomy Surgery?
Carotid endarterectomy procedure may take up to two hours. After the procedure, your doctor may do a test to confirm that the blockage has been removed. Before the procedure, you will undergo a series of physical examinations and other medical assessments. Tell your doctor all the medications, supplements or herbs that you are taking. A few days before surgery, your doctor may or may not instruct you to stop taking blood-thinning medication. If you smoke, you need to stop. Consult your doctor if you need help quitting. Tell your doctor about any illnesses or sickness you may have before your scheduled surgery.
Thoroughly follow your doctor’s instructions on when to stop eating and drinking before your procedure. On the day of your carotid artery endarterectomy, your doctor may allow you to take any medications they prescribe with a small amount of water. Be sure to arrive at the hospital on time and follow other instructions.
How Is Carotid Endarterectomy Performed?
When you have carotid artery surgery, you will either be under general anesthesia, which means you will be asleep and won’t feel pain or you will receive local anesthesia that numbs just the specific surgical area. This helps ensure you're comfortable and pain-free during the procedure. You will also receive medication to help you relax.
During the surgery, you will lie on your back on an operating bed. Your head will be turned to one side so the surgeon can access the affected carotid artery. The surgeon will make an incision in your neck right over the artery. A catheter, which is a flexible tube, may be inserted into the artery to allow blood to bypass the blocked section.
The blocked part of your artery will be opened. The surgeon will remove the buildup of plaque. Once the plaque is cleared out, the artery will be stitched up or patched with material from one of your veins or a synthetic alternative, ensuring that blood can flow freely to your brain again. Throughout the surgery, your vital functions will be monitored closely.
What Happens After Carotid Endarterectomy?
After the surgery, a drain might be placed at the incision site to help remove any fluid that accumulates. This is typically removed within a day. You might need to stay in the hospital overnight so your healthcare team can monitor you for any complications, like bleeding or stroke. Your doctor may allow you to go home the same day if they observe your condition is stable. It's important to follow your doctor’s instructions on how to care for yourself once you’re home to ensure a smooth recovery. Keep in mind that having CEA does not address the underlying issues that caused the artery blockage. To help prevent future problems:
- Eat a heart-healthy diet and exercise based on your doctor's recommendations.
- Quit smoking if you smoke.
- Manage stress effectively.
- Follow your doctor's prescriptions for managing cholesterol.
- Continue taking any prescribed medications for conditions like high blood pressure or diabetes as directed.
- You might also be prescribed medications such as aspirin or clopidogrel to prevent blood clots. Do not stop taking these medications without discussing it with your doctor.
After carotid artery surgery, some patients can expect to return to most of their usual activities within three to four weeks. You might experience a mild neck ache for the first couple of weeks. It is common to experience some numbness along your jaw and near your earlobe due to the surgery. This usually resolves itself within six months to one year. Feel free to start resuming daily activities whenever you feel ready. Hold off on driving until your incision has healed sufficiently and you can turn your head comfortably. It is best to consult your doctor if you have any questions about proper recovery.
Reach out to your healthcare provider if you experience any of the following:
- Headaches, confusion, numbness or weakness in your body.
- Vision problems, speech difficulties or issues understanding others.
- Difficulty moving your tongue or swallowing.
- Severe swelling in your neck.
- Persistent chest pain, dizziness or shortness of breath.
- Coughing up blood or discolored mucus.
- Fever over 101 degrees Fahrenheit (38.3 degrees Celsius) or a persistent fever after taking acetaminophen (Tylenol).
- Redness, pain or discharge from the incision.
- Swelling in your legs.
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