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Carotid endarterectomy is surgery to
plaque buildup in the
carotid arteries. During a carotid
For more information about making the decision to have
The surgery often takes about an hour.
Recuperation includes spending a short time in the recovery room and may
include about 24 hours in the intensive care unit to watch for
The hospital stay usually is 1 to 3 days. And
normal activities can be resumed within a week as long as the activities are
not physically demanding. There may be some aching in the neck for up to 2
weeks. It is important not to turn your head too often or too quickly during
Your doctor may suggest that you have this surgery if:
You are most likely to benefit from surgery if you
have had symptoms and if your carotid artery is narrowed by 70% or more. People with less than 50% narrowing do not
seem to benefit from surgery.1
Carotid endarterectomy is more effective
than treatment with medicine alone in preventing stroke for people who have
symptoms that can be attributed to a 70% to 99% blockage of the carotid
The major risks associated with carotid
Carefully weigh the benefits and
risks of surgery, and compare them with the benefits and risks of medicine
therapy. The success of medicine therapy will depend on how much narrowing
(stenosis) is present in the arteries and the choice of medicine. Risks of
surgery depend on your age, your overall health, the skill and experience of
the surgeon, and the experience of the medical center where the surgery is
Tests such as carotid ultrasound, carotid arteriography, CT
angiography, or magnetic resonance angiography (MRA) are needed before surgery
to evaluate the amount of plaque buildup in the carotid arteries and the flow
of blood through the narrowed area. (For more information, see the Exams and
Tests section of the topic Stroke.) The blood vessels beyond the hardened area
are also evaluated. If those vessels are severely damaged, surgery may not be
Carotid endarterectomy can be done several months
after a stroke or TIA. But people benefit most from the
surgery if it is done within 2 weeks of the stroke or TIA. Delaying surgery longer than 2
weeks increases the risk for stroke, because people are more likely to have a
stroke in the first few days and weeks after a first stroke or a TIA.
The likelihood of complications
from carotid endarterectomy varies, depending on the skill and experience of
the surgeon. The American Heart Association Stroke Council recommends that
surgery be done by a surgeon who has complications in less than 6% of the
endarterectomy surgeries that he or she performs and that the hospital rate of
complications be just as low.2
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
Biller J, et al. (1998). Guidelines for carotid
endarterectomy: A statement for healthcare professionals from a special writing
group of the Stroke Council of the American Heart Association. Circulation, 97(5): 501–509.
Furie KL, et al. (2011). Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. Published online October 21, 2010 (doi: 10.1161./STR.0b013e3181f7d043).
January 7, 2011
E. Gregory Thompson, MD - Internal Medicine & Richard D. Zorowitz, MD - Physical Medicine and Rehabilitation
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