Carotid Artery Surgery

What is carotid artery surgery?

Carotid artery surgery is surgery to restore blood flow to your brain. It is a treatment for carotid artery disease and can help prevent a stroke. Carotid artery surgery involves removing plaque buildup from your carotid arteries.

Carotid artery disease, also called carotid artery stenosis, is a narrowing of your carotid arteries. You have two carotid arteries, one on each side of your neck. They are major arteries that carry blood from your heart to your brain. Carotid artery disease is caused by atherosclerosis, commonly called hardening of the arteries. Atherosclerosis is a buildup of plaque. Plaque is a sticky, waxy deposit of fats, cholesterol, calcium, and fibrous material. Carotid artery disease puts you at risk for stroke.

Carotid artery surgery is major surgery with significant risks and potential complications. You may have less invasive treatment options available depending on your specific circumstances. You should consider getting a second opinion about all your treatment choices before having carotid artery surgery.

Types of carotid artery surgery

The types of carotid artery surgery procedures include:

• Carotid endarterectomy involves opening the carotid arteries in your neck and removing the inner lining that is diseased or damaged by plaque. A patch graft may be placed to help widen the artery and improve the blood flow.
• Carotid artery angioplasty and stenting is an option for patients who have a high risk of complications for carotid endarterectomy. In this procedure, your doctor inserts a very small hollow tube, or catheter, through a blood vessel in your groin or elbow. Your doctor guides the catheter to your carotid arteries. Once the catheter is in place, your doctor opens or widens the artery and places a stent. A stent is a cylinder-like tube made of thin mesh. It holds your artery open after angioplasty. Stents remain in place after your surgery.

Other procedures that may be performed

In addition to carotid artery surgery, your doctor may also perform one or more additional diagnostic procedures. These procedures will tell your doctor how much plaque is in your carotid arteries:

• Carotid angiography is a procedure that allows your doctor to take a picture or image (called an angiogram) of your carotid arteries. This is a minimally invasive test that requires the placement of a catheter into your arm to inject dye into the carotid arteries.
• Carotid ultrasound is a noninvasive, painless screening test that allows your doctor to examine your carotid arteries and evaluate the flow of blood through them.

Why is carotid artery surgery performed?

Your doctor may recommend carotid artery surgery to treat carotid artery disease. Carotid artery disease is a buildup of plaque inside your carotid arteries. This narrows your carotid arteries and can eventually block them completely. This causes less blood to flow to your brain and can put at risk for a stroke.

Your doctor may only recommend carotid artery surgeryif other treatment options with less risk of complications have not been effective. Talk with your doctor about all of your treatment options and consider getting a second opinion.

Your doctor may recommend carotid artery surgeryif you have carotid artery disease and any of the following conditions:

• Prior stroke, which is when the flow of blood to your brain stops
• Prior transient ischemic attacks (TIAs), a group of stroke-like symptoms that generally resolve within 24 hours. However, they are warning signs that you are at risk for a severe stroke.
• Carotid artery stenosis of 60% or greater. Carotid stenosis is a narrowing of your carotid arteries. Your doctor may decide that carotid artery surgery is a good treatment for you if your carotid arteries are narrowed by 60% or more. This is true even if you do not have symptoms and have not had a stroke or a TIA.

How is carotid artery surgery performed?