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 helps prevent 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 risks and potential complications. You may have less invasive treatment options. 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 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. This procedure involves inserting a small tube, or catheter, through a blood vessel in the groin or elbow. Your doctor guides the catheter to your carotid arteries and 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

Your doctor may perform other procedures with carotid artery surgery. These procedures show how much plaque is in your carotid arteries:

  • Carotid angiography makes images (called an angiogram) of the 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 examines the carotid arteries and evaluates blood flow 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 the carotid arteries. This narrows the carotid arteries and can eventually block them completely. This reduces blood flow to the brain and increases the risk of stroke. 

Your doctor may only recommend carotid artery surgery if other treatment options with less risk of complications have been ineffective. Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on carotid artery surgery.

Carotid artery surgery treats carotid artery disease with any of the following conditions: 

  • Carotid artery stenosis of 60% or greater. Carotid stenosis is a narrowing of the 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.
  • Prior stroke, which occurs when the flow of blood to the brain stops
  • Prior transient ischemic attack (TIA), a group of stroke-like symptoms that generally resolves within 24 hours. A TIA is a warning sign that you are at risk for a stroke.

Who performs carotid artery surgery?

The following specialists perform carotid artery surgery:

  • Neurosurgeons specialize in the medical and surgical care of diseases and conditions of the brain, its blood vessels, and the nervous system. 
  • Vascular and interventional radiologists perform carotid angioplasty and stenting. These doctors specialize in the treatment of blood vessel and other conditions using catheter-based procedures and imaging techniques.
  • Vascular surgeons specialize in surgical treatment of diseases of the blood vessels.