What is a carotid endarterectomy?
The carotid arteries are large blood vessels on each side of the neck that carry blood and oxygen to the brain. Over time, the carotid arteries may become blocked with arteriosclerotic plaque (a substance made up of fats and other materials that collect on the artery wall). At times, small pieces of plaque, called emboli, break away from the artery wall and travel to the brain, causing a transient ischemic attack (TIA or "mini" stroke) or a stroke. A TIA and a stroke are symptoms of carotid artery disease and can be diagnosed with several tests. The most common tests are the Carotid doppler and Duplex scans which evaluate blood flow in the carotid artery and detect blockages. A carotid arteriogram is a test during which a dye is injected into the bloodstream and traced through the carotid artery. Another test that may be used to demonstrate the degree of arterial narrowing is called a magnetic resonance angiogram (MRA). If the artery is obstructed, x-ray films will show a narrowing where only a portion of the dye can pass through. If these tests show a significant blockage, your physician may recommend surgical treatment to prevent a stroke.
A carotid endarterectomy is a surgical procedure offered at the Inova Heart Center in which the plaque that is causing the narrowing in one or both carotid arteries is removed.
Preparing for the procedure
Patients will be asked to come into the hospital's Same Day Admission Program a day or two before surgery to have lab work, a chest x-ray, an EKG and a physical exam. A nurse practitioner or physician assistant will discuss the risks of surgery and ask you to sign a consent form. They will also talk with you and your family about what you can expect while you're in the hospital. An Anesthesiologist will talk with you about your medical history and will explain how medication will be given to keep you asleep and free of pain during your surgery.
During the procedure
An Inova vascular or cardiac surgeon will make a short incision on the side of your neck just below the jaw. The carotid artery will be exposed. In most cases, the flow of blood is diverted through a temporary shunt to allow the blood to flow to the brain throughout the procedure. Once the artery is opened, the plaque is gently removed. The artery is closed with stitches or with a dacron patch. The skin incision is then closed with stitches.
After the procedure
Immediately after surgery you will go to the Recovery Room where your vital signs and incision will be constantly monitored. Once you are awake, you will be transferred to a regular hospital room where you will be allowed to be up and around and can eat regular foods. Most patients return home in one or two days.