Carotid endarterectomy is a surgical procedure that removes cholesterol blockage or plaques from the carotid artery. The carotid artery is the main artery in the neck that brings blood to the head. This procedure has been widely used as a way to reduce stroke risk. Studies show carotid endarterectomy benefits certain patients whose carotid arteries are narrowed by 70 percent or more. There's some risk that the surgery may cause a stroke from blood clot that can break loose and travel to the brain, but this complication varies among surgeons and medical institutions.

Other complications also include:

• Nerve injury in the neck causing weakness of your voice box, speech function, or tongue muscles.
• Heart attack during the operation because there is blockage in the carotid artery there might also be the same condition in the blood vessels in your heart.

The procedure may be used to treat symptoms of carotid artery blockage, such as:

• Weakness of the arm, leg, or face on one side of the body
• Inability to move the arm, leg, or face on one side of the body (paralysis)
• Numbness, tingling, or noticeable change in the sensation of the arm, leg, or face on one side of the body
• Difficulty swallowing
• Loss of all or part of vision (blindness) in one eye
• Slurred speech or inability to speak
• Dizziness (vertigo)
• Confusion, fainting, or coma
• Stroke with complete recovery (TIA)
• Severe blockage without any symptoms at all

Seek urgent medical attention if you experience these symptoms. The symptoms may be permanent, but even if they occur briefly and then get better by themselves, they still might be a sign of a serious problem. When symptoms disappear within 24 hours or less, they are called transient ischemic attacks (TIA).

Surgery should also be done for those who have carotid artery blockages which cut off between 70-99 percent of blood flow through this major artery if they experience symptoms. There is evidence that even if there are no symptoms at all, the risk of stroke is reduced with surgery. Speak with your doctor to discuss the risks and benefits if you have no symptoms but have a significant blockage (> 60%) within your carotids.

If there is complete blockage, surgery is almost always advised because the risk of stroke and brain damage is high. X-rays using special dyes (carotid angiogram) can show the degree of blockage of the carotid arteries. Other tests such as ultrasound and magnetic resonance angiography (MRA) can indicate blockages in the carotid arteries.

Risk factors such as age, gender and other illnesses should also be considered prior to surgery.

Carotid Angioplasty with stent placement, lifestyle changes and medical therapy are generally the first-line treatments. These include:

• Controlling hypertension and diabetes
• Treating elevated lipids, quitting smoking
• Moderating alcohol intake
• Increasing exercise
• Using anti-platelet drugs, anticoagulants, or both

Prior to any surgery, your doctor will give you a complete medical examination and evaluate your overall health and your health history. You may be required to get additional tests such as X-rays and lab tests. Your doctor will also review with you the potential risks and benefits of the operation and will ask you to sign a consent form. It is important that you ask questions and be sure you understand the reason for the surgery as well as the risks.

It is important that you inform your doctor if you have allergies to any medications, what medications you are taking, and if you have bleeding problems. It is also important to inform your doctor if you are pregnant.

Your doctor will also give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, taking or avoiding certain vitamins and medications. Carefully following these instructions will help your surgery go more smoothly.

Depending on the circumstances of your surgery, you may be instructed to do the following:

• Completely empty your colon and cleanse your intestines prior to surgery. You may be requested to drink clear liquids only for one or several days prior to surgery.
• Stop eating or drinking after midnight the night before the operation except medications that your doctor has told you are permissible to take with a sip of water the morning of surgery.
• Plan for your care and recovery after the operation. Find someone to drive you home after the surgery. Allow for time to rest and try to find people to help you with your day-to-day duties.
• Stop smoking at least six to eight weeks prior to surgery as smoking delays wound healing. Smokers are also more likely to have breathing problems during surgery.

Following the procedure, you will spend one or two days in the hospital in an intensive care unit (ICU) or special-care post-operation unit where you will be monitored to ensure normal brain functioning, to maintain blood pressure, and to watch for any sign of bleeding from the neck area.

After discharge, you should:

• Limit physical activity for several weeks
• Avoid driving
• Report any changes in brain function, severe headaches or swelling in the neck

You may need a medication that makes the blood less likely to clot after the surgery. In a few weeks you may be able to return to a normal lifestyle.

Re-blockage of the carotid artery, occurs in approximately six percent of patients. To help prevent another blockage, your physician will recommend lifestyle changes, which include:

• Maintaining an ideal weight
• Exercising regularly
• Avoiding foods that are high in cholesterol and saturated fat

A variety of factors may influence the cost of the surgery. They include:

• Insurance coverage
• Pre-existing health
• Insurance co-pay
• Location of the facility

These factors vary depending on you and your situation.

The cost of each procedure can vary dramatically based upon age, location, gender, and insurance coverage. HealthGrades provides detailed cost estimates which include the costs of the procedure, drugs, hospital stay, and more. Each cost estimate is easy to understand and provides medical terms you need to know.

The detailed cost estimate for Carotid Endarterectomy, includes costs for:

• Removal of diseased lining and clots from arteries through incision in the neck.