Home > Health Library > Carotid Endarterectomy for TIA and Stroke
Carotid endarterectomy is surgery to
plaque buildup in the
carotid arteries. During a carotid
The surgery takes about an hour.
You will likely stay one night in the hospital.
Normal activities can be resumed within a week as long as the activities are
not physically demanding. There may be some aching in the neck for up to 2
Your doctor may suggest that you have this surgery if:footnote 1, footnote 2
If you have had a TIA or stroke
You are most likely to benefit from surgery if you
have had symptoms and if your carotid artery is narrowed by 70% or more. People with less than 50% narrowing do not
seem to benefit from surgery.footnote 3
Carotid endarterectomy works better
than treatment with medicine alone in preventing stroke for people who have
symptoms that can be attributed to a 70% to 99% blockage of the carotid
If you have not had a TIA or stroke
If you have not had a TIA or stroke, it is not as clear when endarterectomy might be a good choice. Medicine and lifestyle changes may work as well as surgery to prevent a stroke. Your doctor might recommend an endarterectomy if you have more than 70% narrowing and you have a low risk of having a serious problem from the surgery.footnote 2
The major risks linked with carotid
Carefully weigh the benefits and
risks of surgery, and compare them with the benefits and risks of medicine
therapy. The success of medicine therapy will depend on how much narrowing
(stenosis) is present in the arteries and the choice of medicine. Risks of
surgery depend on your age, your overall health, the skill and experience of
the surgeon, and the experience of the medical center where the surgery is
Carotid endarterectomy can be done several months
after a stroke or TIA. But people benefit most from the
surgery if it is done within 2 weeks of the stroke or TIA. Delaying surgery longer than 2
weeks increases the risk for stroke, because people are more likely to have a
stroke in the first few days and weeks after a first stroke or a TIA.
The likelihood of complications
from carotid endarterectomy varies, depending on the skill and experience of
the surgeon. If you have had a TIA or stroke, the American Heart Association and American Stroke Association recommend that
surgery be done by a surgeon who has complications in less than 6% of the
endarterectomy surgeries that he or she performs and that the hospital rate of
complications be just as low.footnote 1 If you have not had a stroke or TIA, it's important that you have a low risk (less than 3%) of serious problems.footnote 2
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
Kernan WN, et al. (2014). Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 45(7): 2160–2236. DOI: 10.1161/STR.0000000000000024. Accessed July 22, 2014.
Meschia JF, et al. (2014). Guidelines for the primary prevention of stroke: A statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, published online October 28, 2014. DOI: 10.1161/STR.0000000000000046. Accessed October 29, 2014.
Rerkasem K, Rothwell PM (2011). Carotid endarterectomy for symptomatic carotid stenosis. Cochrane Database of Systematic Reviews (4).
ByHealthwise StaffPrimary Medical ReviewerE. Gregory Thompson, MD - Internal MedicineSpecialist Medical ReviewerKarin M. Lindholm, DO - Neurology
Current as ofFebruary 20, 2015
Current as of:
February 20, 2015
E. Gregory Thompson, MD - Internal Medicine & Karin M. Lindholm, DO - Neurology
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