Carotid endarterectomy is a surgical procedureto unblock a carotid artery. The carotid arteriesare themainblood vessels thatsupply the head and neck.
Carotidendarterectomies arecarried out whenone or both carotid arteries become narrowedbecause ofa build-up of fatty deposits (plaque).This is known as carotid artery disease or carotid artery stenosis.
If a narrowed carotid artery is left untreated,blood flow to the brainmay be affected. This is usually because a blood clot forms anda piece breaks off and goes to the brain. This can result ineither:
Each year around 110,000 people have a stroke in the UK andaround a quarterof these are caused by a narrowing of the carotid arteries. More than 5,000 carotidendarterectomy procedures were performed on the NHS between 2011 and 2012.
Carotid endarterectomy can significantly reduce the risk of a stroke in people with severely narrowed carotid arteries.In people who have previously had a stroke or a TIA, their risk of having another stroke or TIA within the next three years is reduced by a third after surgery.
It's now thought the operation should be performed as soon as possible after symptoms appear. It's important to seek immediate medical advice if you experience symptoms such as:
The advantage of local anaesthetic isit allows thesurgeon to monitor brain function while you're awake. However, there's no evidence that either is safer or better.
During the procedure, a 7-10cm (2.5-4 inch) cut will be made between the corner of your jaw and your breastbone. A smallcut is then made along the narrowed section of artery, and the fatty deposits that have built up are removed.
The artery is then closed with stitches or a patch and your skinis also closed with stitches.
However, there's a small risk of more serious complications, which can include stroke or death in around 3% of cases. Nevertheless, this risk is much lower than in people with carotid artery disease who haven't chosen to have the operation.
Instead, a thin flexible tube isguided to the carotid artery through a small cut in the groin.A mesh cylinder (stent) is then placedinto the narrowed section of artery towidenit andallow blood to flow through it more easily.
Carotid stenting is currently thought to be associated with a higher risk of stroke during the procedure, especially if it's performed in the first few days after symptoms appear. However, it's a useful alternative for people who may be at a higher risk of complications from an operation.
A carotid endarterectomy is a surgical procedure to unblock a carotid artery. The carotid arteries are the main blood vessels that supply the head and neck.
A carotid endarterectomy may be needed if one or both of your carotid arteries becomes narrowed by a build-up of fatty deposits (plaque).
Before having a carotid endarterectomy, you'll attend a pre-admission clinic where you'll have a physical examination and be asked about your medical history.
A carotid endarterectomy will either be carried out under general or local anaesthesia.
After a carotid endarterectomy, you will usually be moved to the recovery area of the operating theatre or, in some cases, a high dependency unit (HDU).
As with all types of surgery, there are some risks associated with having a carotid endarterectomy.
A carotid endarterectomy is the main treatment for narrowed carotid arteries. However, an alternative procedure called carotid artery stent placement can also be used.
Mr Joseph Leverment, from Cropston, Leicester, had a carotid endarterectomy while he was a senior surgeon at University Hospitals of Leicester NHS Trust.