Carotid artery surgery is a procedure to restore proper blood flow to the brain. There is a carotid artery on each side of the neck. This artery brings needed blood to the brain and face. The blood flow in this artery can become partly or totally blocked by fatty material called plaque. A partial blockage is called carotid artery stenosis, or narrowing. Blockages in the carotid artery can reduce the blood supply to the brain. A stroke can occur if the brain does not get enough blood.

There are two ways to treat a carotid artery that has plaque buildup. One is surgery called endarterectomy. The other is a procedure called angioplasty with stent placement.

During a carotid endarterectomy, an incision is made in the neck over the carotid artery. The surgeon puts a catheter (a flexible tube) in place to allow blood to flow through the catheter, around the blocked area, during surgery. The surgeon then opens the carotid artery to remove the plaque inside the artery. Once as much of the plaque as possible has been removed, the artery will be closed with stitches, allowing blood to flow through the artery to the brain. Heart and brain activity will be monitored closely during surgery.

Carotid angioplasty and stenting are a less-invasive way to repair the blockage in the carotid artery. The procedure involves making an incision in the groin and inserting a catheter through the incision into an artery. The catheter is then carefully guided up to the neck to the blockage in the carotid artery.

The surgeon will use live x-ray pictures to see the artery. This kind of x-ray is called fluoroscopy. A guide wire is passed through the catheter to the blockage. Another catheter with a very small balloon on the end is then inserted and pushed over the guide wire and into the blockage. The balloon is inflated so it presses against the inside wall of the artery. This step opens the artery and restores proper blood flow to the brain.

A stent, a wire mesh tube, may also be placed in the blocked area. The stent is inserted at the same time as the balloon catheter. It expands when the balloon is inflated. The surgeon then removes the balloon, and the stent is left in place to help keep the artery open.


The risks for any anesthesia are breathing problems and allergic reactions to medicines. The risks for any surgery are bleeding and infection. The risks of carotid surgery include:

  • Blood clots or bleeding in the brain
  • Brain damage
  • Stroke (rare)
  • Heart attack
  • Seizures (rare)
  • Swelling near the airway (the tube the patient breathes through)
  • Allergic reaction to dye (only with carotid artery angioplasty)
  • More blockage of the carotid artery over time

Texas Health is committed to providing quality care to heart and vascular patients throughout North Texas and beyond. While various technologies and services are discussed here, not all of our hospitals offer every treatment and diagnostic technology highlighted. Call 1-877-THR-WELL to learn more about heart and vascular services at a Texas Health hospital near you.

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