How do I prepare for a carotid endarterectomy?
You may be asked to have only liquids for at least a day before the surgery and no liquids after midnight the night before the surgery. You will be given aspirin before the surgery and for at least 3 months afterwards to reduce the risk of stroke, heart attack, or death.7 If you smoke, you should stop smoking 6 to 8 weeks before the surgery because smoking slows down the healing process.
What happens during a carotid endarterectomy?
Carotid endarterectomy can be done with general or local anesthesia; the entire procedure takes about 2 hours. The surgeon will make a small incision on the side of your neck to expose the affected artery. The blood flow through the artery will be stopped with clamps. Your brain will be supplied with blood through the carotid artery on the other side of your neck or through a tube the surgeon inserted to redirect the blood flow around the artery being repaired. An incision is then made in the narrowed artery and the plaque is carefully removed. The artery is stitched up, the clamps or tube are removed, and the neck incision is closed up.
What happens after a carotid endarterectomy?
Immediately after the surgery you will be taken to a recovery room where you will stay a few hours. When the anesthesia has worn off you will be moved to the intensive care unit (ICU) where you will stay for 1 to 3 days to be monitored. After you leave the hospital you will be asked to limit your physical activity for several weeks. You should call your doctor if you notice any swelling in the neck or if you have severe headaches.
Is carotid endarterectomy better than getting a stent?
Carotid endarterectomy is currently the gold standard for the treatment of carotid atherosclerosis. Carotid stenting is a newer, less invasive alternative to carotid endarterectomy. This treatment may be used in women who are at high risk for complications during carotid endarterectomy, or who have narrowing in the carotid artery that is difficult to reach with surgery.2 Carotid stenting is also a reasonable option for women who are eligible for carotid endarterectomy, but do not want to have a surgical procedure. The chance of dying or having another stroke appears to be the same for both procedures;9 research is ongoing to find out whether the less invasive method can reduce the rate of other complications.6
