How carotid endarterectomy is performed

A carotid endarterectomywill either becarried out under general or local Anaesthesia .


Anaesthetic is painkilling medication that allows surgery to take place without a patient feeling pain or discomfort.

If you have a general anaesthetic , you'll be asleep throughout the procedure. You'll remain conscious if you have a local anaesthetic , but the area on your neck will be numbed so you can't feel any pain.

Studies comparing the resultsof carotid endarterectomies found no difference between the two types of anaesthetic. It will be up to you, your surgeon and your anaesthetist (specialist in anaesthesia)to decide which type of anaesthetic to use.

Your surgeon may prefer to use local anaesthetic so youremain conscious during the operation. This allows them to monitor your brain's reaction to the decreased blood supply throughout the procedure.

The procedure

A carotid endarterectomy usually takes one to twohours to perform.If bothof your carotid arteries need to be unblocked, two separate procedures will be carried out. One side will be done first and the second side will be done a few weeks later.

Once you're asleep or the area has been numbed, your neck will be cleaned with antiseptic tostop bacteria getting into the wound. If necessary, the area may also be shaved. A smallcut will then be made toallow thesurgeon to accessyour carotid artery.

During the procedure, your surgeon will decide whetherto use a temporary shunt to maintain adequate blood flow to the brain. A shunt is a small plastic tube that can be used to divert blood around the section of the carotid artery being operated on. The decision to use a shunt is based on surgeon preference and the results of brain blood flow monitoring during the operation.

When the surgeon has access to the carotid artery, the artery is clamped to stop blood flowing through it and an opening is made across the length of the narrowing. If a shunt is to be used, it will be inserted now. The surgeon will thenremove the inner lining of the narrowed section of artery, along withany fatty deposits (plaque) that have built up.

Once the narrowing has been removed,the opening in the arterywill then either be closed with stitches or a special patch. The majority of surgeons in the UKuse a patch, but the choice is down to what the surgeon prefers.

Your surgeon will then check for any bleeding. Thecut in your neck will be closed after any bleeding has stopped. A small tube (drain) may be left in the wound to drain away any blood that might build up after the operation. This is usually removed the following day.

After the procedure

When the operation is finished, you'll usually be moved to the recovery area of the operating theatre, where your health can be monitored to ensure you're recovering well.


Content supplied by the NHS Website

Medically Reviewed by a doctor on 28 Nov 2016