How is carotid artery surgery performed?

Your carotid artery surgery will be performed in a hospital using one of the following approaches:

  • Catheter surgery is a form of minimally invasive surgery used for carotid angioplasty and stenting. It involves inserting a catheter through a vessel in a groin or elbow. X-ray imaging guides the catheter tip to the blocked area of the carotid artery. Your doctor performs the angioplasty using a balloon, laser or drill to open your artery. Your doctor can also place a stent using the catheter. A stent is a cylinder-like tube made of thin mesh. Stents remain in place to keep your artery open after angioplasty.
  • Open surgery is used for carotid endarterectomy. Your surgeon makes an incision or cut in your neck to expose the diseased part of your carotid artery. Your surgeon either clamps your carotid artery closed or places a temporary shunt around your artery. The next step involves cutting open the diseased part of your artery and removing the inner lining, including the plaque buildup. Your surgeon closes your artery—sometimes this requires a “vein patch”—and unclamps it or removes the shunt. Open surgery allows your surgeon to directly view and access the surgical area. Open surgery generally involves a longer recovery and more pain than catheter surgery because it requires cutting and displacement of muscle and other tissues. Despite this, open surgery may be a safer or more effective method for some patients.

Your doctor will advise you on which procedure is best for you and how long you need to stay in the hospital based on your diagnosis, age, medical history, and general health. Learn about the different types of carotid artery surgery and ask why your doctor will use a particular type for you.

Types of anesthesia that may be used

Your doctor will perform carotid artery surgery using either general anesthesia or regional anesthesia, depending on the specific procedure. 

  • Regional anesthesia is also known as a nerve block. It involves injecting an anesthetic around certain nerves to numb a large area of the body. To numb a smaller area, your doctor injects the anesthetic in the skin and tissues around the procedure area (local anesthesia). You will likely have sedation with regional anesthesia to keep you relaxed and comfortable.  For carotid artery surgery, your doctor will use local anesthesia to numb the incision area in your groin or elbow where he or she inserts the catheter. Your doctor may ask you questions during the procedure. This will help monitor your brain’s response to decreased blood supply if your carotid artery is clamped shut. 

What to expect the day of your carotid artery surgery

The day of your surgery, you can generally expect to:

  • A surgical team member will start an IV. 
  • The anesthesiologist or nurse anesthetist will start your anesthesia.
  • A tube is placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgery as they happen.