Carotid endarterectomy is used to correct a blockage or narrowing of the carotid arteries, which take blood to the brain. In a carotid endarterectomy, plaque that has formed inside the artery wall is removed by the surgeon. This surgical procedure can help prevent stroke in patients with carotid artery disease. As with any surgery, there are certain risks associated with this procedure that you should discuss with your Hurley cardiologist beforehand.
Before the procedure
Your Hurley physician will conduct a full medical examination to determine if you are healthy enough for the procedure, and help you understand what to expect before the carotid endarterectomy procedure takes place. Be sure to tell your cardiologist about any medications you are taking, including any over-the-counter medications or supplements, and if you are pregnant or have a pacemaker. Have nothing to eat or drink for 8 hours prior to the procedure. Take all medications as ordered. Shower the evening before and the morning of the procedure, using an antibacterial soap. Arrange for someone to drive you to and from Hurley Medical Center. Prepare to remain at the hospital for 24 to 48 hours. Arrive at Hurley two hours prior to your procedure.
During the procedure
After admission to Hurley Medical Center’s cardiac holding unit, you will be prepared for the procedure. You will be asked to remove jewelry or other objects that might interfere with the procedure, and will be given a gown to wear instead of your own clothing. You may be given a sedative to help you relax.
An IV line will be placed in your arm for fluids and medications, while other catheters may be inserted in your wrist and/or neck in order to monitor blood pressure and heart function and to take blood samples. Depending on the extent of the procedure, you will be given a local anesthetic or a general anesthetic. In either case, the medical team will help minimize pain and ensure that you are breathing comfortably, whether on your own or with the help of a breathing tube and ventilator.
The skin in the area where the procedure is to be performed will be cleansed and an incision will be made on the side of the neck where the affected carotid artery is located. The artery will be opened and the plaque removed. During this time, a shunt may be used to make sure that blood continues to flow to the brain. After the plaque is removed, the artery will closed (using bandages or stitches) and dressed, and normal blood flow will begin to the brain.
You will then be moved into a recovery area, where a drain may be placed in your neck to collect and remove any accumulated blood in the area of the surgery. You will be monitored to make sure that you are able to respond to questions, and to confirm that your blood pressure, pulse and breathing have stabilized. You may then be moved to the ICU or your hospital room, where you will remain until you are ready to be released. You will be given pain medications as needed, and allowed solid foods as you recover.
Take your antibiotics and other medications as ordered by your Hurley physician. Be sure to keep your incision clean and dry until it has healed. Your physician will give you specific instructions on how and when you can bathe while you continue to recover. Stitches, if any, will be removed during your follow-up visit with your physician—call ahead for an appointment. If you experience fever or chills, or redness, swelling, bleeding or increased pain at the site of the incision, call your physician right away.