Carotid Endarterectomy for Stroke

Treatment of hemorrhagic stroke focuses on controlling the bleeding and reducing pressure in your brain caused by the excess fluid.

A carotid endarterectomy is a surgical procedure for hemorrhagic stroke involving the removal of fatty deposits from one or both of the main blood vessels located in the neck. These blood vessels are the carotid arteries and are responsible for supplying blood to the brain. As people age, they often develop problems with their carotid arteries, which can be a primary factor in stroke. The disease process that causes the buildup of fat and other material (plaque) on the artery walls is called atherosclerosis, better known as a hardening of the arteries.

A carotid endarterectomy usually takes 1 or 2 hours to perform. If not one but both of the carotid arteries need to be unblocked, one artery will generally be done first and a second procedure will need to be performed some weeks later.

The procedure is done with the aid of an anesthetic, and the patient will either be unconscious or numbed. The surgeon makes a small cut to allow access to the artery and then clamps it to stop blood flow, giving them access to make an opening along the length of the artery.

The surgeon then removes the inner lining of the artery, including any plaque that has built up. After closing the artery and checking for bleeding, the surgeon closes the cut on the neck. A small tube may be left in the wound to drain away any residual blood that may build up after the surgery. This tube is usually removed the next day.