Carotid endarterectomy is the surgical procedure to remove fatty plaque from neck arteries. Fatty plaque is deposited on the interior walls of the neck (carotid) atteries as a in a condition known as Carotid Artery Disease. Carotid Artery Disease affects the vessels leading to the head and brain. Like the heart, the brain's cells need a constant supply of oxygen-rich blood. This blood supply is delivered to the brain by the 2 large carotid arteries in the front of the neck and by 2 smaller vertebral arteries at the back of the neck. The right and left vertebral arteries come together at the base of the brain to form what is called the basilar artery. A stroke most often occurs when the carotid arteries become blocked and the brain does not get enough oxygen.
Carotid Endarterectomy Procedure Description
While the patient is under anesthesia, surgeons make an incision in the neck, at the location of the blockage. A tube is inserted above and below the blockage to reroute blood flow. Surgeons can then open up the carotid artery and remove the plaque. Once the artery is stitched closed, the tube is removed. 
The surgeon may also use an alternate technique that does not require blood flow to be rerouted. In this procedure, the surgeon stops the blood flow just long enough to peel the blockage away from the artery.
Endarterectomy surgery is a treatment that has been proven safe and effective in providing long-term benefits to patients. A Multidisciplinary Consensus Statement from the American Heart Association recently (1995) concluded that carotid endarterectomy, performed in medical centers with documented successful experience in the procedure, in conjunction with aggressive modifiable risk factor management, is beneficial for patients who have an asymptomatic carotid artery disease with more than 60% artery diameter reduction. The Statement also concluded that carotid endarterectomy is of proven benefit for symptomatic patients, including those with single or multiple transient ischemic attacks (TIAs) or those who have suffered a mild stroke within a 6-month interval, who have stenosis of greater than 70%.
Carotid artery disease increases the risk for stroke in 3 ways:
- By fatty deposits called plaque severely narrowing the carotid arteries.
- By a blood clot becoming wedged in a carotid artery narrowed by plaque.
- By plaque breaking off from the carotid arteries and blocking a smaller artery in the brain (cerebral artery).
What are the symptoms of carotid artery disease?
Although there are no symptoms specific to carotid artery disease, the warning signs of a stroke are a good way to tell if there is a blockage in the carotid arteries. Transient ischemic attacks (TIAs) are one of the most important warning signs that you may soon have a stroke. Sometimes called "mini-strokes," TIAs are temporary episodes of headache, dizziness, tingling, numbness, blurred vision, confusion, or paralysis that can last anywhere from a few minutes to a couple of hours. See a doctor right away if you or someone you know has the symptoms of a TIA.
Other signs or symptoms of a carotid artery blockage may be
- Weakness or paralysis of your arm, leg, or face on one side of your body.
- Numbness or tingling of your arm, leg, or face on one side of your body.
- Trouble swallowing.
- Loss of eyesight, or blurry eyesight in one eye.
- Dizziness, confusion, fainting, or coma.
Surgical Associates of Texas, P.A., the surgical team at the Texas Heart Institute, have more experience than any other cardiovascular surgical group in the world, having performed approximately 100,000 open heart surgeries of all types and degrees of complexity and over 800 heart transplants. Many of our patients have had successful operations and recovery when previously led to believe no further treatment options were possible.
If you are interested in learning more about any of these procedures, please visit our pages on Surgical Procedures . Please visit our page on carotid artery disease to learn more about it.