Carotid Endarterectomy and Carotid Stenting

What is it?

Carotid endarterectomy and carotid angioplasty and stenting are treatments for carotid artery disease. 

Carotid endarterectomy: This surgery removes plaque from inside the carotid artery. It increases blood flow to the brain and reduces the risk of stroke. 

Carotid angioplasty and stenting: This minimally invasive procedure improves blood flow through carotid arteries blocked by plaque. It is done from within the blood vessel, or endovascularly. Your care team uses imaging to guide a balloon catheter (thin plastic tube) through your blood vessels to the carotid artery. The balloon is inflated, stretching the artery open. Then a stent (small mesh tube) is placed to hold it open. 

Figure A shows the location of the right carotid artery in the head and neck. Figure B shows the inside of a normal carotid artery. Figure C shows the inside of a carotid artery that has plaque buildup and reduced blood flow.

How the procedures are done

Carotid endarterectomy

Dr Tsotetsi makes an incision in the neck, separates the artery from surrounding tissue, and opens it.  Blood flow to the brain is rerouted. He then removes the plaque from the artery before closing it with stitches or a patch.

Carotid angioplasty with stenting

Dr Tsotetsi uses imaging to guide a catheter with a balloon tip to the narrow part of the artery. The balloon is inflated, widening the artery and pressing the plaque against the artery walls to improve blood flow. A protective device catches any plaque that’s dislodged. A stent is placed to hold the artery open.