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Definition of Endarterectomy Procedure
Endarterectomy is an operation to surgically remove accumulations of atherosclerotic plaque (atheromas) from the arteries.
The most common site for endarterectomy is the carotid arteries, which carry blood to the head and brain.
During endarterectomy, the surgeon makes a small incision through the skin and into the artery at the site of the atheroma, briefly stops the flow of blood through the artery and removes the atheroma, restores blood flow, and sutures the artery closed.
Endarterectomy is a major surgery done under general anesthesia, typically with 24 to 48 hours of inpatient hospitalization following the operation
Depending on the location and size of the atheroma the surgeon may place a shunt in the artery to allow blood to flow around the site of the atheroma during the operation. The shunt maintains blood supply to the brain and helps prevent atherosclerotic fragments from escaping into the blood flow to the brain.
Endarterectomy is a fairly high risk procedure because of the potential for dislodging fragments of the atheroma during the procedure. When this happens, there is no way to prevent the fragments from traveling up the carotid artery to the brain where they cause stroke.
About 3 percent of people who undergo endarterectomy experience stroke, ranging in severity from imperceptible symptoms to disability or death. Cardiologists recommend endarterectomy when the occlusion is 80 to 99 percent.
Studies show that endarterectomy can lower the risk for stroke even when carotid stenosis does not cause symptoms, though because of the risk that the operation itself can result in stroke, some cardiologists recommend surgery only when the blockage causes symptoms.