Carotid endarterectomy, is a surgery to remove plaque from the carotid arteries. These are the two large arteries on each side of your neck. They supply oxygen-rich blood to your brain.
Carotid endarterectomy is used to prevent stroke, or "brain attack," in people who have carotid artery disease. Carotid artery disease occurs when plaque builds up in the carotid arteries.
Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque hardens and narrows the arteries. This limits or blocks the flow of oxygen-rich blood to your brain, which can lead to a stroke.
A stroke also can occur if the plaque in an artery cracks or ruptures. Blood cells called platelets stick to the site of the injury and may clump together to form blood clots. Blood clots can partly or fully block a carotid artery.
The illustration shows the process of a carotid endarterectomy. Figure A shows a carotid artery with plaque buildup. The inset image shows a cross-section of the narrowed carotid artery. Figure B shows how the carotid artery is cut and how the plaque is removed. Figure C shows the artery stitched up and normal blood flow restored. The inset image shows a cross-section of the carotid artery with plaque removed and normal blood flow restored.
Your vascular surgeon may choose to give you local anesthesia so he or she can talk to you during the surgery. This allows the surgeon to check your brain's reaction to the decrease in blood flow that occurs during the surgery. General anesthesia temporarily puts you to sleep. Local anesthesia numbs only certain areas of your body.
During a carotid endarterectomy, your surgeon will make an incision in your neck to expose the blocked section of the carotid artery. He or she will put a clamp on your artery to stop blood flow through it.
During the procedure, your brain gets blood from the carotid artery on the other side of your neck. However, your surgeon also may use a tube called a shunt to move blood around the narrowed or blocked carotid artery.
The surgeon will make an incision in the blocked part of the artery. To remove the plaque, he or she will remove the inner lining of the artery where the blockage is.
Your surgeon will close the artery with stitches and stop any bleeding. He or she will then close the incision in your neck.