For more information about making the decision to have surgery, see:
The surgery takes about an hour. Recuperation includes spending a short time in the recovery room and may include about 24 hours in the intensive care unit to watch for complications.
The hospital stay usually is 1 to 3 days. And normal activities can be resumed within a week as long as the activities are not physically demanding. There may be some aching in the neck for up to 2 weeks. It is important not to turn your head too often or too quickly during your recovery.
Your doctor may suggest that you have this surgery if:
You are most likely to benefit from surgery if you have had symptoms and if your carotid artery is narrowed by 70% or more. People with less than 50% narrowing do not seem to benefit from surgery.1
Carotid endarterectomy works better than treatment with medicine alone in preventing stroke for people who have symptoms that can be attributed to a 70% to 99% blockage of the carotid arteries.2
The major risks linked with carotid endarterectomy are:
Carefully weigh the benefits and risks of surgery, and compare them with the benefits and risks of medicine therapy. The success of medicine therapy will depend on how much narrowing (stenosis) is present in the arteries and the choice of medicine. Risks of surgery depend on your age, your overall health, the skill and experience of the surgeon, and the experience of the medical center where the surgery is done.
Carotid endarterectomy can be done several months after a stroke or TIA. But people benefit most from the surgery if it is done within 2 weeks of the stroke or TIA. Delaying surgery longer than 2 weeks increases the risk for stroke, because people are more likely to have a stroke in the first few days and weeks after a first stroke or a TIA.
The likelihood of complications from carotid endarterectomy varies, depending on the skill and experience of the surgeon. The American Heart Association Stroke Council recommends that surgery be done by a surgeon who has complications in less than 6% of the endarterectomy surgeries that he or she performs and that the hospital rate of complications be just as low.2
- Rerkasem K, Rothwell PM (2011). Carotid endarterectomy for symptomatic carotid stenosis. Cochrane Database of Systematic Reviews (4).
- Furie KL, et al (2011). Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 42(1): 227–276. Also available online: http://stroke.ahajournals.org/content/42/1/227.full.
Last Revised: January 3, 2013
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