What are the risks and potential complications of carotid artery surgery?  

As with all surgeries, carotid artery surgery involves risks and possible complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery. 

General risks of surgery 

The general risks of surgery include: 

  • Anesthesia reaction, such as an allergic reaction and problems with breathing 
  • Bleeding, which can lead to shock
  • Blood clot, in particular a deep vein thrombosis that develops in the leg or pelvis. A blood clot can travel to your lungs, heart or brain and cause a pulmonary embolism, heart attack, or stroke.
  • Infection and septicemia, which is the spread of a local infection to the blood

Potential complications of carotid artery surgery

Complications of carotid artery surgery include:

  • Bleeding in the brain and brain damage
  • Damage to an artery from the catheter or balloon
  • Heart attack
  • Hyperperfusion syndrome. This can occur when your brain suddenly receives normal blood flow after surgery. A severe headache that improves when you are upright is a classic symptom.
  • Low blood pressure, which is usually temporary
  • Nerve damage, which is usually temporary. This can make it difficult to swallow and cause numbness in your face.
  • Restenosis, or re-blockage of your carotid artery
  • Seizure (rare)
  • Stroke
  • Sudden vessel occlusion. This is a total blockage of the artery at the site of your angioplasty. Sudden vessel occlusion is a rare complication that typically occurs within 24 hours of angioplasty. It requires immediate medical attention.
  • Throat swelling, making it difficult to breathe

Reducing your risk of complications

You can reduce the risk of some complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery
  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage 
  • Taking your medications exactly as directed
  • Telling all members of your care team if you have any allergies 

How do I prepare for my carotid artery surgery? 

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome. 

You can prepare for carotid artery surgery by:

  • Answering all questions about your medical history and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.
  • Getting preoperative testing as directed. Testing varies depending on your age, health, and specific procedure. Preoperative testing may include a carotid duplex ultrasound, CT scan, chest X-ray, EKG (electrocardiogram), blood tests, and other tests as needed.
  • If you have high blood pressure, talk to your doctor about how to control it both before and after surgery. Good blood pressure control can help decrease your risk of complications with carotid artery surgery.
  • Losing excess weight before the surgery through a healthy diet and exercise plan
  • Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.
  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and help the healing process.
  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners.

Questions to ask your doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before carotid artery surgery and between appointments. 

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Why do I need carotid artery surgery? Are there any other options for treating my condition?
  • Which type of carotid artery surgery procedure will I need?
  • How long will the surgery take? When can I go home?
  • What restrictions will I have after the surgery? When can I return to work and other activities?
  • What kind of assistance will I need at home?
  • What medications will I need before and after the surgery? How do I take my regular medications?
  • How will you treat my pain?
  • When should I follow up with you?
  • How should I contact you? Ask for numbers to call during and after regular office hours.