Carotid endarterectomy is a type of vascular surgery that may be an option for patients who have carotid artery disease, or narrowing in the carotid arteries that supply blood to the brain. This narrowing usually occurs due to build-up of fatty deposits, or plaque (called atherosclerosis). When atherosclerosis builds up in the carotid arteries, blood flow to the brain may be impaired, increasing the risk of stroke. Additionally, small pieces of plaque may dislodge and block a vessel in the brain, leading to stroke. Carotid endarterectomy for carotid artery disease treatment improves blood flow through the carotid arteries by removing the plaque from inside the diseased artery.
To perform a carotid endarterectomy, a surgeon makes an incision on the side of the neck where the affected carotid artery is located. The surgeon opens the artery and removes the plaque, then sutures the artery back together to restore normal blood flow to the brain.
An alternative to carotid endarterectomy for selected patients who are at high risk for surgery is balloon angioplasty with stenting, which is a minimally invasive procedure requiring only a small incision in the groin. Similar to a coronary angioplasty used to open narrowed coronary arteries in the heart, a carotid artery angioplasty uses a small balloon threaded into the carotid artery to flatten the plaque and improve blood flow. A stent may then be used to ensure the artery remains open.
For state-of-the-art treatment of carotid artery disease, including carotid endarterectomy, patients in the Boston area can turn to the Carl J. and Ruth Shapiro Cardiovascular Center at Brigham and Women's Hospital.
Carotid Endarterectomy Procedure:
This video animation demonstrates a carotid endarterectomy, an open surgical procedure that treats carotid stenosis. Stenosis is the narrowing of the vessel in the carotid artery due to a blockage. This makes it difficult for blood to get through the carotid artery and into the brain, which left untreated could lead to a stroke. A neurosurgeon/neuro-interventionalist makes an incision along the side of the neck to expose the vessel. Clips are placed before and after the area of vessel narrowing. These clips temporarily stop blood flow, to allow operation on the stenotic area. Occasionally a temporary bypass (blue tube) is used to keep blood flow, but this is not always necessary. The vessel is then opened, the block is removed, and the vessel is closed up. The clips and temporary bypass are removed (if applicable) and the neck incision is closed. (This animation does not have sound.)
The Shapiro Cardiovascular Center at Brigham and Women's Hospital is equipped with the latest technology and staffed by a team of physicians and caregivers who are among the country's best providers of cardiovascular care. Our specialists at the Center deliver rapid, accurate, and advanced assessment and treatment for patients with cerebrovascular diseases, including carotid endarterectomy for stroke prevention, as well as stroke treatment and coronary disease treatment. Combining innovative and compassionate care with leading-edge research into new treatments for artery disease and therapies for other cardiovascular conditions, the Center has helped Brigham and Women's Hospital earn a reputation as one of the top cardiovascular centers in the country.
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