The Vascular Surgery team at the University of Michigan is dedicated to providing exceptional patient care in the U-M Cardiovascular Center (CVC), our new state-of-the-art clinical building.

Our surgeons have extensive experience performing the carotid endarterectomy procedure and have pioneered new techniques for the treatment of carotid artery disease.

What is carotid endarterectomy?

As you age, plaque - a material made of cholesterol, calcium and fibrous tissue - can build up along the walls of your arteries. As more plaque accumulates, your arteries narrow and stiffen. Eventually, enough plaque builds up to reduce blood flow or cause irregularities in the normally smooth inner walls of the arteries.

Carotid endarterectomy - one of the most commonly performed vascular operations - is a safe and long-lasting treatment for this condition. Carotid endarterectomy is the surgical removal of the artery inner lining and plaque to restore blood flow.

Who is a good candidate for carotid endarterectomy?

You are a good candidate for a carotid endarterectomy if you have severe narrowing of your carotid arteries, especially if you are experiencing TIAs and are otherwise in reasonably good health.

List of U-M Vascular Surgeons Who Perform Carotid Endarterectomy

For details about education, experience, and specialty in this clinical area, please visits these physician profile pages:

How do I prepare for a carotid endarterectomy?

Your doctor will give you detailed instructions. These may include a suggestion to eat a light meal the night before the procedure and to not eat or drink anything after midnight before the procedure. If you regularly take any important medicines, your provider may ask you to take them on the day of surgery with a sip of water.

Follow your doctor's instructions about not smoking before and after the procedure. Smokers heal more slowly after surgery. They are also more likely to have breathing problems during surgery. For this reason, if you are a smoker, you should quit at least 2 weeks before the procedure. It is best to quit 6 to 8 weeks before surgery. Also, your body will heal much better if you do not smoke after the surgery.

How is the procedure performed?

You will be given a general anesthetic to relax your muscles, put you in a deep sleep, and prevent you from feeling pain during the operation. Once the anesthesia takes effect, the medical team will shave the skin on your neck to help prevent infections. Your surgeon then makes a cut (incision) on one side of your neck to expose your blocked carotid artery. Then temporarily clamps will be put on your carotid artery to stop blood from flowing through it. During the procedure, your brain receives blood from the carotid artery on the other side of your neck or through a temporary shunt inserted to detour the blood around the artery that is being repaired.

After your surgeon clamps your carotid artery, he or she makes an incision directly into the blocked section. The plaque deposit it then peeled out by removing the inner lining of the diseased section of your artery. After removing the plaque, your surgeon stitches your artery closed, removes the clamps or the bypass, and stops any bleeding. He or she then closes your neck incision and the procedure is complete. Sometimes, a patch is used to widen the artery as part of the procedure. The patch material can be your own vein, usually from the leg, or a variety of synthetic materials depending on your specific case.

What happens after the procedure?

At first you will stay in an intensive care unit or special post-operation unit. When your condition is stable, you will be taken to a regular room. You may stay in the hospital 1 to 2 days, depending on your condition. You may need medicine that makes the blood less likely to clot after the surgery. Patients are often able to return to their normal activities in a few weeks.

If you notice any change in brain function, severe headaches, or swelling in your neck, you should contact your physician immediately.

Because you had plaque in your artery, you should eat less fat and try to exercise more after you have recovered from the procedure. Ask your doctor what other steps you should take and when you should come back for a checkup.

Are there any complications?

As with any surgical procedure, you may have complications following a carotid endarterectomy. Although this risk is very low (from 1 and 3 percent), a stroke is one possible complication. Another uncommon complication is the development of another blockage in the same artery, called restenosis. This may occur later, especially if you continue to smoke, in approximately 2 to 3 percent of cases. Another unusual complication is temporary nerve injury, with symptoms that include hoarseness, difficulty swallowing or numbness in the face or tongue. This condition usually fades in less than 1 month and generally does not require any treatment.

It is important to note that the chance of any of these complications is much less than the risk of stroke if a significant carotid blockage is not adequately treated.

How can I take care of myself?

Follow the treatment plan prescribed by your healthcare team.

Do not smoke.
Eat a healthy diet that is low in fat and cholesterol.
Exercise according to your health care provider's recommendation.
Keep your appointment for your scheduled post-discharge office visit.

When should I call my doctor?

Call your doctor right away if:

You have chest pain.
You have constant or worsening pain or numbness in your arm or leg.
You have a fever.
You have shortness of breath.
You have bleeding, excess bruising, or a lot of swelling at the surgical site.

Make an appointment or contact us for more information.