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
- Allergic reaction to dye (only with carotid artery
- 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.