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Surgery for carotid artery disease
Surgery is a potential option for patients with more significant carotid
Two options exist, 1) carotid endarterectomy, and 2) carotid
angioplasty with stenting.
In endarterectomy, the surgeon cuts into the
artery, removes the plaque buildup and repairs the artery incision.
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
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.