As with all types of surgery, there are some risks associated with having a carotid endarterectomy.
The two main risks are:
- stroke: the risk of stroke is around 3% for people who do not have any prior symptoms and 6% for people with prior symptoms (see below)
- death: there is a 1% risk of death
Although strokes after carotid endarterectomy are relatively rare, most are caused by an artery in the brain becoming blocked during the early post-operative period, or because there is some bleeding into the brain tissue. Your surgical and anaesthetic team will do everything they can to prevent this.
Risk factors
Factors that increase your risk of stroke or death as a result of surgery include:
- your age: the risk increases as you get older
- whether you smoke
- a previous stroke or transient ischaemic attack (TIA): the risk will depend on the severity of the stroke or TIA, how well you recovered and how recently it occurred
- whether you 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
Complications
Most people don't develop complications after having surgery to unblock a carotid artery. However, the above risk factors increase your likelihood of developing complications.
Possible complications following surgery 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 and weakness or numbness on the side of your face; it affects around 8% of people but is usually temporary and disappears within a month
- narrowing of carotid artery again: this is called restenosis; further surgery is required in about 2%-4% of people
Your surgeon should explain the risks that are associated with a carotid endarterectomy before you have the procedure. Ask them to clarify anything that you're not sure about and answer any concerns that you have.
