Carotid endarterectomy at Nuffield Health at St Bartholomew's Hospital

What is a carotid endarterectomy?

The build up of plaque can cause the carotid arteries to narrow and restrict the flow of blood.

For some patients, medication, diet and lifestyle changes may be prescribed to treat this narrowing. For others surgical removal of the plaque called carotid endarterectomy may be required.

What happens during a carotid endarterectomy?

Before your procedure

Before your endarterectomy your consultant may order one or more tests to access the flow of blood in your carotid arteries.

During your procedure

Carotid endarterectomy can be performed under general or local anaesthetic. Be sure and ask your consultant what method will be used. The procedure takes 1-2 hours. If both your carotid arteries are blocked you may need two procedures within a few weeks.

Your consultant will make an incision (cut) in your neck and access your carotid artery. They will clamp the area of your artery containing the plaque to temporarily restrict the flow of blood. If needed, they may temporarily reroute the flow of blood from the area.

After carefully opening the carotid, your surgeon will peel away the plaque from the artery wall. In some cases they may insert a tiny tube (stent) to strengthen the artery and hold it open. After checking to ensure there is no residue left in the artery they will close the opening using stitches or a patch. The incision in your neck will also be closed. A small drainage tube may be left in place to drain away any excess fluid. This tube will usually be removed the day after your surgery.

After your procedure

You may need to stay in hospital for up to 2 days following your surgery. Our healthcare team will closely monitor your blood pressure and heart rate. You will be given pain relief medication.

Most patients are able to eat and drink within a few hours of surgery.

Recovery from carotid endarterectomy

Please arrange for someone to drive you home on your day of discharge. You will not be able to drive until released to do so.

Keep your wound clean and dry until your appointment to remove your stitches. Any scar will fade after a few months.

You may be given medication to prevent blood clots. Continue to take this as prescribed.

Your consultant may recommend diet and lifestyle changes to help prevent further narrowing of your arteries.

Be sure and discuss any return to work or exercise with your consultant or GP.

Risks

Most people make a good recovery from carotid endarterectomy. As with any surgical procedure there could be complications including:

• Bleeding
• Infection
• Pain
  

Specific complications of carotid endarterectomy may include:

• Voice change
• Difficulty swallowing
• Further narrowing of the carotid artery
• Stroke
• Death (rare)