Understanding Carotid Endarterectomy: Benefits and Recovery Insights
Carotid endarterectomy is a surgical procedure that helps to prevent strokes in patients with a narrowed carotid artery. This artery supplies blood to the brain, and when it becomes blocked, the risk of stroke increases.
The blockage is usually caused by plaque buildup in the internal carotid artery. Removing this plaque can restore blood flow and reduce the risk of stroke. Stroke prevention is the most important reason why this surgery is performed.
There are two main carotid arteries, one on each side of the neck. Each splits into the internal carotid artery and the external carotid artery. A narrowed carotid artery, often caused by carotid artery disease or stenosis, reduces the amount of blood reaching the brain. Over time, this can lead to a stroke or a transient ischemic attack. Carotid endarterectomy is done to remove plaque and improve blood flow.
This surgery is often recommended for symptomatic patients who have experienced stroke-like symptoms or have already had a stroke. It is also considered for some asymptomatic patients if they are at higher risk. A trained vascular surgeon does The carotid endarterectomy procedure in a hospital. Carotid revascularisation endarterectomy is the technical term used when restoring normal blood supply by removing the blockage.
What Is Carotid Endarterectomy?
Carotid endarterectomy is a vascular surgery to remove plaque buildup from the carotid artery. This plaque causes carotid artery stenosis. The plaque comprises fat, cholesterol, calcium, and other substances that build up on the artery wall. When this buildup becomes severe, it restricts blood flow and increases the chance of stroke.
During the endarterectomy procedure, the surgeon makes an incision in the neck to reach the carotid artery. The artery is opened, and the plaque is carefully removed. Sometimes, patch angioplasty is done to widen the artery and reduce the chance of future blockage. After the plaque is removed, the artery is stitche,d and blood flow is restored.
The procedure may be performed under general or local anaesthesia. It usually takes one to two hours, and the patient may stay in the hospital for one to two days.
Who Needs a Carotid Endarterectomy?
Not all patients with carotid artery disease need surgery. Some may be treated with medicines and lifestyle changes. Carotid endarterectomy is recommended for specific patient groups where the risk of stroke is high. These are some of the main factors considered:
1. Symptomatic patients with 70% or more blockage
Patients who have had a transient ischemic attack, minor stroke, or stroke-like symptoms and are found to have severe carotid stenosis may benefit from surgery. Surgery in these patients can significantly reduce the chance of another stroke.
2. Asymptomatic patients with high grade carotid stenosis
Even if the patient has no symptoms, if the narrowing is more than 70% and other risk factors are present, doctors may suggest surgery. This is to reduce the future risk of stroke.
3. Patients with moderate carotid stenosis and other conditions
When patients have 50–69% narrowing along with other risk factors such as high blood pressure or diabetes, the decision depends on the patient’s overall health. The benefit of carotid surgery must be greater than the risk.
4. Those unsuitable for carotid artery stenting
Carotid stenting is an alternative procedure. But if the patient’s artery anatomy or age makes stenting risky, then carotid endarterectomy may be a better choice.
5. Individuals with recurrent symptoms
If symptoms return even after medical treatment, it may be due to poor blood flow from a narrowed carotid artery. Surgery may be necessary to remove the blockage and improve brain function.
The Carotid Endarterectomy Procedure Explained
The carotid endarterectomy procedure is done in a hospital setting by a vascular surgery specialist. It is a planned surgical procedure. Patients are usually admitted a day before or the same day of the operation. The goal is to improve blood flow to the brain and reduce stroke risk. Below is a breakdown of how the surgery is done.
1. Pre-surgical preparation
Patients undergo tests like carotid ultrasound, CT scan, or angiography to measure blockage in the common carotid artery or internal carotid artery. Blood pressure and other conditions are also checked. Patients may be advised to stop blood thinners or other medicines.
2. Anaesthesia and incision
The surgery can be done using general anaesthesia or local anaesthesia depending on the patient’s condition. The surgeon makes an incision on the neck, typically along the anterior border of the sternocleidomastoid muscle, to reach the carotid sheath.
3. Plaque removal
The internal carotid artery is opened after clamping. The surgeon removes the plaque buildup causing the narrowing. This step is critical and is done with precision to avoid damage to the artery wall or cranial nerves.
4. Patch angioplasty
A patch may be sewn to the opened artery to prevent re-narrowing. This technique widens the artery and reduces the chance of future blockage. The patch may be made from synthetic material or a vein from the patient.
5. Closure and recovery
After restoring the blood flow, the surgeon closes the incision. The patient is monitored in a recovery room. Most patients stay for 1–2 days depending on complications. Recovery involves monitoring for stroke symptoms, blood pressure, and overall brain function.
Procedure Comparison Table:
| Feature | Carotid Endarterectomy | Carotid Artery Stenting |
|---|---|---|
| Invasiveness | Surgical (open) | Minimally invasive |
| Anesthesia | General or local | Local with sedation |
| Hospital Stay | 1–2 days | Same-day or overnight |
| Best for | Older patients, tight plaque | Younger patients, high-risk surgery |
| Risk of Stroke (30 days) | 3%–5% (lower in older adults) | 4%–7% |
Benefits of Carotid Endarterectomy
Carotid endarterectomy lowers the risk of future strokes. It is most useful in patients with carotid artery stenosis, especially when the narrowing is 70% or more. This surgery removes the plaque that blocks the artery and helps restore blood flow to the brain. When blood flow improves, brain function improves, too.
The goal is to prevent future events like strokes or transient ischemic attacks. For people who have already had a stroke, the surgery may prevent another one. It can also improve symptoms such as dizziness, numbness, and trouble with speech or vision.
Patients with high blood pressure often see better control after this surgery. It is usually recommended when the benefits outweigh the risks of the procedure.
1. Stroke Risk Reduction
One of the strongest reasons to perform carotid endarterectomy is to reduce the risk of stroke. Studies show that the risk of a second stroke drops by up to 55% in people with 70% or more artery narrowing. This is a major reason why symptomatic patients are advised to have surgery. It removes the direct cause of stroke, plaque blocking blood flow.
2. Improved Blood Flow to the Brain
The surgery restores blood flow through the internal carotid artery. When the blockage is removed, oxygen and nutrients can reach brain tissue properly. Better blood flow helps brain function, lowers stroke risk, and reduces symptoms caused by low blood supply.
3. Helps with Symptoms in Symptomatic Patients
Patients with symptoms like weakness, numbness, slurred speech, or vision changes may feel better after the surgery. These symptoms are caused by poor blood flow or small strokes. Clearing the blockage can ease or stop these symptoms from returning.
4. Better Than Stenting for Some Groups
In older patients or those with certain artery shapes, carotid endarterectomy works better than carotid artery stenting. Surgery may have fewer stroke-related complications in these cases. Doctors choose the method that gives the best result based on age and artery condition.
5. Supports Long-Term Brain and Heart Health
After surgery, patients often manage their blood pressure and cholesterol better. Follow-up care helps keep the artery open. This supports not just the brain but also reduces the strain on the heart. Lifestyle changes after surgery also help in preventing future plaque buildup.
Cost Estimate Table:
| Cost Component | Estimated Range (INR) | Notes |
|---|---|---|
| Surgery Fee | 60,000 – 1,20,000 | Based on surgeon experience and case complexity |
| Hospital Stay (2 days avg.) | 20,000 – 50,000 | May vary by hospital type and location |
| Anesthesia and OT Charges | 15,000 – 30,000 | Depends on anesthesia type used |
| Pre-surgery Investigations | 5,000 – 15,000 | Imaging, blood tests, ECG, etc. |
| Post-op Medicines & Recovery | 10,000 – 20,000 | Includes follow-up, wound care, scans |
These costs are estimates and may vary based on city, hospital, patient condition, and length of stay.
Recovery After Carotid Endarterectomy
Recovery after carotid endarterectomy is an important part of the overall treatment. The goal is to heal properly, avoid complications, and return to daily activities while reducing the risk of stroke.
The hospital stay is usually short, around 1 to 2 days, depending on the patient’s health. Close observation is required during this time to ensure that blood flow to the brain is stable and there are no signs of stroke or cranial nerve damage.
Recovery involves wound care, blood pressure monitoring, and follow-up imaging tests. Patients are also advised to make lifestyle changes to maintain healthy arteries. The full recovery period typically lasts 2 to 4 weeks.
1. Hospital Stay and Early Recovery
Patients are monitored closely for stroke symptoms, blood pressure changes, and oxygen levels. Doctors also check for issues such as swelling, bleeding, or nerve problems. Patients may receive medicines to prevent blood clots and manage blood pressure.
2. Wound Care and Healing
The neck incision must be kept clean and dry. Doctors usually remove stitches after a week. Pain at the incision site is normal. Patients should avoid heavy lifting or bending to prevent strain on the surgical area.
3. Activity and Movement
Most patients can walk within 24 hours. Light activities are allowed during the first few days. Strenuous exercise, driving, or physical work should be avoided for 2–3 weeks. Doctors will advise you when you can resume normal activity.
4. Diet and Medication
A heart-healthy diet helps in long-term recovery. Medicines are prescribed to control blood pressure, cholesterol, and prevent blood clots. Regular follow-up is necessary to adjust medications based on your healing progress.
5. Signs to Watch For
Contact your doctor immediately if you experience new weakness, slurred speech, chest pain, or severe headache. These could be signs of stroke or complications.
Recovery Timeline Table
| Time After Surgery | hExpected Recovery Stage |
|---|---|
| 0–2 days | Hospital monitoring, pain management |
| 3–7 days | Stitches in place, limited activity |
| 1–2 weeks | Stitches removed, start walking regularly |
| 2–4 weeks | Resume normal activities gradually |
| 1 month+ | Follow-up imaging and routine checkups |
Your Recovery Begins with SRM Global Hospitals
Carotid endarterectomy can reduce stroke risk by removing plaque from the internal carotid artery and improving blood flow to the brain. Recovery takes time, but is usually smooth with proper care. Life after the surgery involves regular monitoring and lifestyle changes to prevent future narrowing.
The cost of the carotid endarterectomy procedure varies based on the hospital, use of general anaesthesia or local anaesthesia, and any complications that may occur. Patients should always speak to their healthcare provider to understand the full cost.
Carotid surgery can prevent future strokes, especially in patients with symptomatic carotid artery stenosis. Endarterectomy helps manage artery disease and supports better brain function.
Consult SRM Global Hospitals Today. If you or a family member is facing carotid artery disease or has been advised to undergo carotid endarterectomy, consult with the vascular surgery team at SRM Global Hospitals. We provide full care from diagnosis to post-surgery support.
Schedule a consultation today with SRM Global Hospitals and take the next step in stroke prevention.
FAQs
1. How painful is the recovery after carotid endarterectomy?
Most patients experience mild to moderate neck pain. Pain is usually controlled with medicines. Swelling or tightness near the incision may last a few days. Serious pain should be reported.
2. Can I travel soon after surgery?
Short-distance travel is possible within a few days. Long trips, especially air travel, should be avoided for 2–4 weeks. Always ask your doctor about your recovery.
3. Will I need carotid endarterectomy on both sides?
Sometimes both carotid arteries are blocked, but surgery is done on one side at a time. Doctors wait several weeks between surgeries to avoid risks.
4. Is carotid stenting better than surgery?
Stenting versus endarterectomy depends on the patient’s age and condition. Endarterectomy is often preferred in older adults because the stroke risk is lower.
