Risks of carotid endarterectomy

As with all types of surgery, there are risks associated with having a carotid endarterectomy.

The two main risks are:

• Heat exhaustion and heatstroke the risk of stroke is around2%, although this may be higher in people who had a stroke before the operation
• death there's a less than 1% risk of death, which can occur as a result of complications such as a stroke or heart attack

Moststrokes that occur after carotid endarterectomy are caused by an artery in the brain becoming blockedduring the early postoperative period, or because there's some bleeding into the brain tissue.

This may happen if the procedure causes a blood clot to move and block an artery. Your surgical and anaesthetic team will do all they can to prevent this.

Other complications

As well as stroke and death, there's a small chance of developing other complications after having a carotid endarterectomy. These include:

• pain or numbness at the wound site this is temporary and can be treated with painkillers
• bleeding at the site of the wound
• wound infection the wound where the incision was made can get infected; this affects less than 1% of people and is easily treated with antibiotics
• nerve damage this can cause a hoarse voice andweakness or numbnesson theside of your face; itaffects around 4% of people, but is usually temporary anddisappears within amonth
• narrowing of the carotid artery again this is called restenosis;further surgery is required in about 2-4% of people

Your surgeon should explain the risks associated with a carotid endarterectomy before you have the procedure.Askthem to clarify anything you're not sure about and answer any concernsyou have.

Increased risk

Factors thatincrease your risk of experiencing complications because of a carotid endarterectomy include:

• your age the risk increases as you get older
• whetheryou smoke
• having previously had a stroke or transient ischaemic attack (TIA) therisk depends on the severity ofthe stroke or TIA, how well you recovered, and how recently it occurred
• whetheryou have a blockage in your other carotid artery as well
• whether you have other health conditions such as cancer , heart disease , high blood pressure (hypertension) or diabetes