Carotid Endarterectomy

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Approximately 700,000 stroke cases occur annually in the United States, and up to half of those may be caused by carotid artery disease, according to the Society for Vascular Surgery.

A carotid endarterectomy works to prevent stroke. It's a surgical procedure to remove the build-up of deposits and improve blood flow inside the carotid arteries, which are located in the neck and supply blood to the brain.

The surgery is done to stop symptoms of reduced blood flow, including stroke, digestive problems and leg cramps. A carotid endarterectomy is one of the most common vascular procedures in the United States and has long-lasting benefits for patients.

UVA's Expertise

Our multidisciplinary team for carotid surgery includes vascular surgeons, heart doctors and members of UVA's stroke team, including stroke neurologists and stroke neuroradiologists. Because their area of expertise includes the neck, UVA's neuroradiologists are able to help vascular surgeons map out treatment plans for carotid artery disease patients.

UVA performs about 120 CEAs each year. Research studies have shown that patient outcomes are better at hospitals that perform more than 100 CEAs annually.

Carotid Artery Disease

W. Darrin Clouse, MD, discusses the causes, symptoms and treatment of carotid artery disease.

What to Expect

At UVA, our vascular surgeons will give you an exam to make sure you're healthy enough for surgery and order detailed images of your arteries.

You may have:

  • General anesthesia—blocks any pain and keeps you asleep through the surgery; given through an IV in your hand or arm
  • Local anesthesia—numbs an area of your body so that you stay awake through the surgery; may be given as an injection

Incisions will be made over the diseased part of the artery. If surgery is done on the neck, the doctor may first reroute (bypass) the blood around the surgical site. This will keep blood going to the brain.

The surgeon will then clean out the inside of the artery, being careful not to have small fragments of the deposits break off and flow downstream. Once the artery is cleaned out, the skin will be closed with sutures or staples. The procedure may take several hours, depending on the severity of your condition.

Carotid Angioplasty and Stenting

If a patient is unable to undergo a carotid endarterectomy for any reason, such as having plaque that can't be accessed surgically or being unable to undergo general anesthesia, another option is an angioplasty and stenting procedure.

In this procedure, a surgeon inserts a catheter with a balloon on its tip and runs it to the area of the carotid artery that is blocked or narrowed. The balloon is inflated, pushing the plaque to the artery walls and opening up the artery. A small metal scaffolding called a stent is then inserted to keep the artery open.