What Is a Carotid Endarterectomy (CEA)?

Surgically Removing the Buildup of Plaque in the Carotid Artery

Surgeons performing surgery in operating room
Surgeons performing surgery in operating room. Getty Images/Morsa Images/DigitalVision

A carotid endarterectomy (ka-ROT-id END-ar-ter-EK-to-me), also known as CEA, is a surgical procedure to treat carotid artery disease. It removes plaque (plak) that has built up in a carotid artery. This buildup of plaque is known as atherosclerosis.  Surgery is performed on patients who have more than 70 percent blockage in their artery in order to prevent stroke.

Plaque is composed of fat, cholesterol, calcium, and other substances found in blood. It tends to harden (atherosclerosis) and narrow (stenosis) over time limiting or blocking of blood flow to the brain causing a stroke. If the plaque within the carotid artery cracks or bursts, fragments of blood cells may join together to form blood clots. The formation of these blood clots can partially or fully block a carotid artery also causing a stroke.

A stroke occurs when the flow of oxygen-rich blood is prevented from going to the brain. There are two types of stroke; hemorrhagic and ischemic. Hemorrhagic strokes are caused by bleeding in the brain. Ischemic strokes are caused by the blockage of blood flow in an artery leading to the brain. Ischemic strokes are the most common type of stroke. A major risk factor for an ischemic stroke is atherosclerosis of the carotid arteries.

Symptoms of a Stroke

Symptoms of a stroke include the following:

  • Sudden numbness, weakness or paralysis of the face, arm or leg
  • Confusion, trouble talking or understanding speech
  • Inability to see in one or both eyes
  • Problems walking, a loss of balance or coordination
  • A severe headache with no apparent cause

The Carotid Endarterectomy Procedure

After a local or general anesthetic has been administered, the surgeon will make an incision along the front of the neck to open the carotid artery, where the blockage exists, and remove the plaque. The artery is then repaired with stitches or a patch graft, a patch made with a vein or artificial material. Depending on the extent of the surgery and the health of the patient, patients may leave the same day or the day after the procedure.

In addition to the percentage of stenosis, risk factors for the surgery include the following:

  • Gender
  • The type of stroke symptoms
  • The amount of blockage on the opposite side
  • Diabetes

Results of a Carotid Endarterectomy

The carotid endarterectomy procedure may lower the risk of stroke for those patients who have a narrowed or blocked carotid artery or symptoms of stroke or transient ischemic attack (TIA).  It can also lower the risk of stroke in people who have a blockage yet have no stroke symptoms.

After the procedure, patients may be given medication to prevent clotting. This helps to reduce blood clotting and lower the risk of stroke.

Reducing the Risk of Stroke

Steps can be taken to further reduce the likelihood of future strokes. Maintaining a healthy diet, controlling blood pressure, reducing cholesterol levels, controlling blood sugar levels and quitting smoking are some measures to take.

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