Strong Heart and Vascular Center

Division of Vascular Surgery

Carotid Endarterectomy

Diagnosis

Arteriosclerosis, or "hardening of the arteries" can affect any artery in the body. The carotid arteries, located on each side of your neck, carry blood to your brain and are unusually susceptible to buildup of atherosclerotic plaque. If enough builds up, pieces can break off and go to the brain, or clots can form on the surface with the same result. This is one of the most common causes of stroke in the western world. If the embolus goes to your eye you can suffer temporary or permanent loss of vision, and if it goes to your brain you can suffer temporary or permanent stroke (a temporary stroke is often called a transient ischemic attack, TlA, or ministroke)

Today's Visit

We will perform ultrasound testing if data do not already exist. We will also discuss your medical history, the details of your situation, and options for treatment in better detail.

What You Can Do

If you smoke, it is extremely important to quit. You should also take an antiplatelet medication such as aspirin or an equivalent. It is also important to keep your weight and blood pressure under control, and to exercise as much as possible.

Nonsurgical Treatment

If you have no symptoms and your blockage is less than 80% or so, observation is usually recommended, with ultrasounds performed at approximately six month intervals. Even if you have had a symptom, observation is usually recommended if your blockage is less than 50%.

Surgery

It must be emphasized that each individual case is different, but in general surgery is safer than observation if you have had a symptom and have a blockage 50% or more or have had no symptoms but have a blockage of 80% or more. Stents are sometimes recommended but are currently (late 2002) only available by enrollment in a research trial. An angiogram is not required. The operation (carotid endarterectomy) can be done under local or general anesthesia depending on several factors, and typically takes an hour or so.

After Surgery

If all goes well, you'll will be in the hospital overnight, and can go home the morning after surgery. At home, you can gradually resume normal activities as tolerated, but should work upto things slowly. You will be fairly independent with your personal care, but should plan to have someone at home with you to help with meals, house keeping, grocery shopping, and so on, for the first week or so. You may shower and wash the wound normally unless other instructions have been given. Numbness along the jaw line and earlobe is normal as the result of this incision, and if present often goes away after 6-12 months. We would ask you not to drive until the wound has healed enough to make turning your head comfortable. You will see your surgeon 2 to 4 weeks after discharge for routine follow-up. Although everyone is different, full recovery typically takes a month or so.