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Endarterectomy

Pronounced: END-art-er-EK-toe-mee

by Ricker Polsdorfer MD
En Español (Spanish Version)
Definition
Reasons for Procedure
Possible Complications
What to Expect
Call Your Doctor

Definition

Endarterectomy is a surgery to remove build-up in blood vessels. It is most often done in:

  • Carotid arteries—in the neck that supply blood to the brain
  • Aorta—largest artery in body, affects blood flow to entire body
  • Iliac and femoral arteries—in the legs
  • Renal arteries—kidney blood supply

Reasons for Procedure

Plaque is a build-up on the lining of blood vessels. It can cause the artery to narrow and harden. This build-up and damage to the blood vessel is known as atherosclerosis. The plaque can slow and even stop blood flow. It can lead to stroke, weakness, cramps, and aching.

Endarterectomy is done to remove the build-up. It should improve blood flow. The symptoms should also improve.

Bilateral Carotid Artery Atherosclerosis
Nucleus image

Copyright © Nucleus Medical Media, Inc.

Possible Complications

The care team will go over possible problems that may occur such as:

  • Bleeding
  • Stroke, highest risk with carotid arteries
  • Blood clots
  • Bad reaction to the anesthesia
  • Infection

Your doctor will talk about things that increase the risk of problems such as:

Your risk of problems may also be higher if there is plaque build-up in other areas.

What to Expect

Prior to Procedure

An exam will be done to make sure you are healthy enough for surgery. Images of the arteries will be reviewed.

Let the doctor know about any medicine you are taking. Some medicine may need to be stopped up to 1 week before the procedure.

  • Avoid food and drink after midnight the night before.
  • Arrange for a ride home from the hospital.

Anesthesia

Anesthesia will be based on where the artery is. Options include:

  • General anesthesia—blocks any pain and keeps you asleep
  • Local anesthesia—numbs an area but you will be awake

Description of the Procedure

Incisions will be made over the artery. Blood flow can be stopped to some areas until the work is done. Blood flow through the neck cannot be stopped. A new pathway will be made to allow blood flow while the artery is cleared out. A small tube or a piece of a vein may be used to create the new path.

A tube will be inserted into the artery. A sharp blade will trim the plaque away from the wall. A device can also help to catch and pull out loose plaque. The artery and skin will then be closed with sutures or staples.

How Long Will It Take?

The length will depend on the amount of plaque and place. It often takes several hours.

How Much Will It Hurt?

There will be some pain at the incisions. Medicine can help to ease pain.

Average Hospital Stay

You may be able to leave the same day or need to stay 1 day to 1 week. The stay may be longer if problems happen.

Post-procedure Care

At the Hospital

Care after the procedure may include:

  • Monitor for problems such as bleeding, clotting, or infection
  • Steps to manage pain

Hospital staff will take steps to lower the risk of infection such as:

  • Wash their hands
  • Wear gloves or masks
  • Keep your incisions covered

Steps you can take to lower the risk of infection include:

  • Wash your hands often. Remind visitors and care team to do the same.
  • Remind your care team to wear gloves or masks.
  • Do not allow others to touch your wounds.

At Home

Plaque can build up again. Medicine and a healthy diet may stop or slow more plaque growth.

Call Your Doctor

After you leave the hospital, contact your doctor if any of the following occurs:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
  • Nausea or vomiting
  • Pain that is not helped with medicine
  • Constipation or diarrhea
  • Problems passing urine
  • Lightheadedness
  • Severe headaches
  • Problems with speech or vision
  • Cough, shortness of breath, or chest pain

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

American Heart Association
http://www.heart.org

Society for Vascular Surgery
https://vascular.org

CANADIAN RESOURCES:

Heart and Stroke Foundation of Canada
http://www.heartandstroke.ca

Public Health Agency of Canada
https://www.canada.ca

REFERENCES:

Atherosclerosis endarterectomy. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/articles/pad-endarterectomy. Accessed September 19, 2019.

Carotid artery stenosis repair. EBSCO DynaMed website. Available at:https://www.dynamed.com/management/carotid-artery-stenosis-repair/. Updated July 25, 2019. Accessed September 19, 2019.

Carotid endarterectomy. Society for Vascular Surgery website. Available at: https://vascular.org/patient-resources/vascular-treatments/carotid-endarterectomy. Accessed September 19, 2019.

6/3/2011 DynaMed Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T905141/Treatment-for-tobacco-use: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.

Last reviewed September 2020 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC  Last Updated: 9/15/2020