Carotid Artery Disease - Surgery

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Surgery for carotid artery disease

Surgery is a potential option for patients with more significant carotid artery disease.

Two options exist, 1) carotid endarterectomy, and 2) carotid angioplasty with stenting.

  1. In endarterectomy, the surgeon cuts into the artery, removes the plaque buildup and repairs the artery incision.
  2. In angioplasty and stenting, a vascular surgeon or interventional radiologist inserts a catheter into the artery and inflates a balloon squashing the plaque into the artery wall. A stent or cage is then placed at the site to keep the artery open and prevent renarrowing.

Surgery is recommended for symptomatic patients who have carotid artery narrowing greater than 70%. Surgery may or may not be of benefit for symptomatic patients whose narrowing is between 50% and 69%.

Some patients decide to be screened by ultrasound for carotid artery disease even though they have no symptoms. Surgery is a controversial treatment option for asymptomatic patients who have narrowing greater than 60%.

Surgery is not recommended for patients:

  • who have completely blocked arteries because the body may have developed collateral circulation that bypasses the blockage.
  • who have already suffered an irreversible stroke because there is no benefit to restoring blood supply to an area of the brain that has already died.
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