A carotid endarterectomy (CEA) is a surgical procedure to remove fatty deposits from the carotid arteries. These are the two main arteries that supply blood to the brain, face, and neck. They are on either side of the neck.

Fatty deposits known as plaque can build up in the carotid arteries due to high blood pressure, high cholesterol, or obesity. This buildup can cause the carotid arteries to narrow, increasing the risk of blockages or the formation of blood clots.

If a blockage or blood clot occurs in the carotid arteries, blood cannot flow to the brain properly, and a person may be at risk of serious conditions such as a stroke.

A carotid endarterectomy (CEA) is a medical procedure that removes plaque from the carotid arteries, restoring proper blood flow to the brain.

This article discusses what CEA involves and the conditions it can treat. It also looks at the benefits and risks of the procedure.

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There are two surgical techniques for CEA that a doctor may perform: the conventional method and the eversion method.

Conventional method

For this technique, a surgeon will make a small incision in the neck to reach the carotid artery and place a clamp on it to stop the flow of blood.

A surgeon will open the carotid artery along the site of the narrowing and sometimes put in a temporary shunt if necessary. A shunt diverts blood flow around the artery to avoid disrupting the blood supply to the brain while the surgeon is working.

The surgeon can then clear the blockage in the artery and repair it with a patch. The patch will also widen the inside of the artery. The surgeon will remove the shunt before finally closing the artery.

Eversion method

For this technique, a surgeon will make a cut across the beginning point of the carotid artery. This is the point at which the single artery branches into two.

The surgeon will then turn the artery inside out and remove the plaque by dividing it into sections.

A surgeon will then repair the carotid artery by connecting both pieces back together.

This method is less common and depends on each surgeon’s training and experience.

CEA can treat carotid artery disease, which occurs when there is a buildup of plaque in the carotid arteries.

Learn about the symptoms of carotid artery disease.

The primary benefit of CEA is that it can help prevent a stroke. A person can discuss the benefits of carotid endarterectomy with their doctor and learn more about the procedure.

To prepare for CEA, a doctor may recommend that a person start taking antiplatelet medications. These can help stop blood clots from forming in the carotid arteries.

A doctor may advise a person to stop smoking before CEA. Smoking can slow the healing process and put a person at risk of a blood clot.

If a person has overweight or obesity, a doctor may recommend losing weight by following a healthy diet before the procedure. It is important to avoid strenuous exercise if a person is a candidate for CEA, as this can be dangerous. A person’s doctor can advise on which exercises may be safe for them.

After CEA, a person will typically stay in the hospital for around 1–2 days. A doctor will closely monitor blood pressure and vital signs. A person may experience soreness at the wound site.

Once a person leaves the hospital, they should avoid strenuous activity or heavy lifting for a number of weeks afterward. A person’s doctor will offer specific instructions on when they can return to work and resume physical activity. They can also recommend gentle exercises to perform in the meantime.

A doctor may also prescribe blood thinning medications such as aspirin or clopidogrel.

As with any procedure, there are risks associated with CEA. Stroke occurs in approximately 2% of people who have CEA, though this is more likely in people who have previously had a stroke. In some cases, stroke can be fatal.

Other possible risks include:

  • bleeding
  • infections
  • nerve damage
  • difficulty swallowing
  • transient ischemic attack (TIA), which is a minor stroke
  • swelling and bleeding in the brain
  • heart attack

A person can discuss the possible risks of CEA with their doctor to help them make an informed decision about their treatment plan.

Here are some frequently asked questions about CEA.

Is carotid endarterectomy a major surgery?

Although the risks of CEA are low, there is still a risk of loss of life, typically due to stroke or heart attack. Therefore, a doctor would typically classify CEA as a major surgery.

What is life expectancy after a carotid endarterectomy?

A 2019 study suggests that 67.6% of people over the age of 80 years survive for at least 5 years following CEA.

An older study from 2006 suggests that, for people of all ages, the survival rate after CEA is 78.2% after 5 years and 45.5% after 10 years.

It is important to note that the outlook following CEA will be different for each individual. A person’s doctor can provide more accurate information based on their individual circumstances.

What is the recovery time after a carotid endarterectomy?

Recovery time following CEA is typically 3–4 weeks. A person should try to avoid strenuous activity or driving before this time. A person’s doctor can provide them with more information about when they will be able to resume regular activities.

A carotid endarterectomy (CEA) is a medical procedure that involves removing fatty deposits from the carotid arteries. These fatty deposits, known as plaque, can occur when a person has high blood pressure, high cholesterol, or obesity.

The plaque can accumulate in the carotid arteries, causing them to narrow and increasing the risk of blockages or blood clots.

Before CEA, a person may need to take blood thinning medication such as aspirin. For some people, a doctor may also advise losing weight before the procedure.

Following CEA, a person may need to stay in the hospital for 1–2 days to recover. Once at home, it may take up to 4 weeks before a person can resume doing regular physical activities, driving, and working.