Carotid endarterectomy is the standard surgical procedure to treat carotid artery disease which occurs when plaque builds up in the two larger arteries on each side of your neck (the carotid arteries). The carotid arteries supply your brain with oxygen-rich blood. This condition can also be treated with a minimally invasive endovascular intervention called carotid artery angioplasty with stenting (CAS). Your vascular surgeon will discuss with you which option is best for you.
The narrowing of the carotid arteries is most commonly related to atherosclerosis (a buildup of plaque, which is a deposit of fatty substances, cholesterol, cellular waste products, calcium, and fibrin in the inner lining of an artery). Atherosclerosis, or "hardening of the arteries," is a vascular disease (disease of the arteries and veins). Carotid artery disease is similar to coronary artery disease, in which blockages occur in the arteries of the heart.
Board-certified surgeons at Brigham and Women’s Hospital (BWH) are high-volume performers in all types of vascular procedures including surgical treatment for carotid artery disease. This experience, and their collaboration with a multidisciplinary team of cardiovascular specialists, enables our surgeons to handle the most complicated cases, providing a range of treatment options that improve the lives of cardiac patients throughout the world.
With 47,000 outpatient visits each year, the BWH Heart & Vascular Center is one of the largest in the United States, treating over 7,000 inpatients and performing more than 8,000 procedures annually at our state-of-the-art Shapiro Cardiovascular Center.
A carotid endarterectomy is performed through a small incision in the neck and involves a "shelling out" of the plaque which removes the plaque from the inside of the artery wall. This restores normal blood flow through the artery to the brain. The operation is generally well tolerated and involves a one- to two-day hospital stay.
Carotid endarterectomy can greatly reduce the risk of stroke in people who have carotid artery disease. A stroke can occur if the plaque in a carotid artery cracks or ruptures. Blood cell fragments called platelets stick to the site of the injury and may clump together to form blood clots. Blood clots can partly or fully block a carotid artery.
A piece of plaque or a blood clot also can break away from the wall of the carotid artery. The plaque or clot can travel through the bloodstream and get stuck in one of the brain's smaller arteries. This can block blood flow in the artery and cause a stroke.
The BWH Heart & Vascular Center is located in the Shapiro building, across the street from BWH’s main 75 Francis Street entrance. The Center brings together the full range of services in one location, fostering seamless and coordinated care for all cardiovascular patients.
If you are having surgery or a procedure, you will likely be scheduled for a visit to the Watkins Clinic in the Shapiro Center for preoperative information and tests.
The day of your surgery, your care will be provided by surgeons, anesthesiologists and nurses who specialize in vascular procedures. After surgery, you will recover in the post-surgical care unit where you will receive comprehensive care by an experienced surgical and nursing staff.
During your surgery, family and friends can wait in the Shapiro Family Center where staff members will provide surgery updates.
In addition to our vascular surgeons, patients also benefit from the teamwork of medical cardiologists, interventional cardiologists, cardiovascular imaging experts and radiologists, and anesthesiologists, all experts in cardiovascular disorders. They work alongside nurses, physician assistants, physical therapists, dietitians and social workers to achieve outstanding outcomes for our patients.