Carotid artery surgery

Alternative names:

carotid endarterectomy

Definition:

A surgical procedure to remove fat and cholesterol build-up (plaque; atherosclerosis) from inside the carotid artery in the neck and restore adequate blood flow to the brain.

Description:

There are four carotid arteries, two on each side of the neck: right and left internal carotid arteries, and right and left external carotid arteries. The carotid arteries deliver oxygen-rich blood from the heart to the head and brain. When the carotid arteries become blocked by fat and cholesterol build-up, the patient experiences brain symptoms, such as stroke. By removing the fat and cholesterol build-up inside the artery, adequate blood flow is restored.

While the patient is deep asleep and pain-free (using general anesthesia), an incision is made in the neck, over the blocked carotid artery. A tube is inserted above and below the blockage to re-direct the blood flow while the surgeon opens the carotid artery and removes the fat and cholesterol build-up. The artery is stitched (sutured) closed, the tube is removed, and the incision is closed.

Indications:

Symptoms of carotid artery blockage, such as:

• weakness of the arm, leg, or face on one side of the body
• loss of ability to move (paralysis) the arm, leg, or face on one side of the body
• numbness, tingling, or noticeable change in the sensation of the arm, leg, or face on one side of the body
• difficulty swallowing
• loss of all or part of vision (blindness) in one eye
• slurring of speech or inability to speak
• dizziness (vertigo)
• confusion, fainting, or coma
• stroke with complete recovery

Many symptoms may be permanent.

X-ray studies using special dyes (carotid angiogram) can show the degree of blockage of the carotid arteries.