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.
Carotid endarterectomy may be needed if one or both carotid arteries have become narrowed by a build-up of fatty deposits (plaque). When the carotid arteries become narrowed it is known as carotid artery stenosis.
If a narrowed carotid artery is left untreated, a blood clot may form, resulting in a:
- stroke: a serious medical condition where the blood supply to the brain is cut off, leading to brain damage or death
- transient ischaemic attack (TIA): sometimes known as a "mini-stroke", a TIA is similar to a stroke but the signs and symptoms are temporary and usually disappear within 24 hours
Read more about why carotid endarterectomy may be needed in some cases.
Carotid arteries
There are two carotid arteries which are located on each side of the neck. They start at the aorta (the largest artery in the body) in the chest and enter the head at the base of the skull. The carotid arteries provide the main supply of blood to the brain.
Normal, healthy arteries are elastic and smooth on the inside, allowing blood to easily flow through them. As a person gets older, plaque can build up inside the arteries, making them narrower and stiffer. This process is called atherosclerosis.
Atherosclerosis
The plaque that causes atherosclerosis is made up of several substances, including:
As well as ageing, there are several other factors that can contribute to a build-up of plaque, including:
- a high-fat diet
- hypertension (high blood pressure)
- diabetes: a long-term condition that is caused by too much glucose (sugar) in the blood
- smoking
Read more about atherosclerosis.
Carotid endarterectomy
Carotid artery disease occurs when one or both carotid arteries become narrowed (stenosis).
Each year in the UK, around 150,000 people have a stroke (one person every five minutes). Carotid stenosis is responsible for around 45,000 (30%) of all strokes. Of these, about 15,000 people (10% overall) have a severe narrowing that needs an operation.
Carotid endarterectomy will usually be advised if one or both of your arteries are more than 50% blocked and you have had recent symptoms.
Surgery may also be recommended for some people without a previous history of symptoms but who have a carotid stenosis that blocks one or both arteries by more than 70%.
Carotid endarterectomy can significantly reduce the risk of a stroke. 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.
Read more about how carotid endarterectomy is performed.
Risks
The carotid endarterectomy procedure does have some associated risks. For example, there is a 3%-5% risk of having a stroke during surgery. However, this risk is much lower than the risk of a person with carotid artery disease having a stroke without surgery.
Read more about the risks of carotid endarterectomy.
