Vascular Surgery: What To Expect on the Day of Surgery

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On the day of your vascular surgery procedure, your preparation will include a physical examination and an assessment of your vital signs. There are many different types of vascular surgical procedures—your operation may involve open surgery or minimally invasive techniques, and it can last between 30 minutes to several hours.

You will begin to recover from surgery and anesthesia in the hours after your operation. You may need to stay overnight in the hospital—this depends on which type of vascular condition you have, and whether you have underlying issues that necessitate close monitoring. 

Common Conditions Treated

Vascular surgery is done to treat specific types of diseases of the arteries and veins. Once you are diagnosed with vascular disease, your healthcare provider will talk to you about whether you would benefit from surgical repair. You might need to have an angioplasty, a bypass surgery, and/or removal of plaques from the diseased vessel.

One of the most common vascular surgery procedures is a carotid endarterectomy. During this procedure, plaques are removed from one or both carotid arteries; carotid arteries supply blood and oxygen to the brain. Carotid artery disease can cause a stroke if left untreated.

Before the Surgery

Vascular surgery can be done as an inpatient or an outpatient/day surgery procedure. This depends on the vascular condition being treated. 

Here are the steps to take before any type of vascular surgery:

  • Abstain from eating or drinking: You should abstain from food and drink after midnight the night before your surgery. This includes water and medication—unless otherwise instructed by your healthcare provider.
  • Take a special shower: This is done as instructed by a healthcare professional the night before—and again the morning of—your surgery using a special type of antibacterial soap.
  • Only take the medications that your healthcare provider instructed you to take: This will be included in your preoperative instructions, which should have been given to you in writing before your surgery.
  • Perform regular oral care: Brush your teeth on the morning of surgery.
  • Remove all makeup: Avoid hairspray, lotions, or body oils on the day of surgery.
  • Take out any piercings: This includes earrings, nose rings, belly button jewelry, and any other type of jewelry for piercings elsewhere in the body. Don't wear or bring rings, jewelry, and/or other valuables.
  • Pack some comfortable, loose-fitting clothing: You can bring a robe and skid-resistant slippers with you to wear after your procedure.
  • Ensure that you have any legal documents with you: This includes power of attorney or guardianship paperwork.
  • Bring your photo ID: A passport or your driver’s license will work.
  • Bring a list of all medications you take: Be sure to include the dosage and schedule for each drug, vitamin, supplement, herbal medicine, or any other medication you take—including topical skin lotions, creams, or eye drops.
  • Remove your contact lenses: Do this at home if you have glasses for a backup, otherwise, you will need to remove them before surgery.
  • Take your glasses, hearing aids, and dentures: Be sure to bring with you any carrying cases to store prosthetics and other sensory devices during your surgical procedure.
  • Bring any assistive devices: If you use a CPAP machine, make sure you take it to the hospital if you will be staying overnight.

After You Arrive at the Facility

Once you arrive at the hospital or at the outpatient center for your surgery, you can expect to:

  • Sign in, provide your name and date of birth
  • Show your identification and your insurance card

After checking in at the front desk, you will meet with a nurse who will:

  • Provide you with a hospital gown to wear during your surgery
  • Review any medications you have taken, noting the dosages and the times you took them
  • Start an intravenous (IV) line by inserting a needle into your vein, usually in your hand or arm

After meeting with a nurse, you will meet with the anesthesiologist who will:

  • Go over your medical history, including whether you have had any type of reaction to anesthesia in the past, such as nausea or an allergic reaction.
  • Explain what type of medication you will be receiving during your surgery
  • Answer any questions you may have about your anesthesia

Prepare for Your Surgery

When it's time for your surgery, your visitors will be asked to wait in the visitors’ area, and you will be taken to the operating room. Once you get positioned properly on the operating table, your anesthesiologist will administer general anesthesia (which will put you to sleep) or local anesthesia if you are having minor surgery.

During the Surgery

Each type of vascular surgery procedure will differ according to the specific steps involved. 

Here is what you would expect if you are having a carotid endarterectomy:

  1. You will be taken to the surgical suite and positioned on your back supine (lying down), with your head turned to the side so your operative carotid artery will face upward.
  2. You will be given medication to help you relax.
  3. You will receive medicine to put you to sleep in your IV or local anesthesia to numb the area being operated on instead of general anesthesia.
  4. Your surgical area will be cleaned with a surgical cleansing solution.
  5. The surgeon will make an incision on your neck in the area over the carotid artery.
  6. A catheter (flexible tube) might be placed into the artery.
  7.  Blood circulates through the catheter and around the blocked area to continue providing adequate oxygenation to the brain during the surgery.
  8. An incision is made to open the carotid artery and the surgeon removes the plaque inside the blood vessel.
  9. The carotid artery is sewn shut with stitches or closed by using a patch graft (a patch made with a vein or artificial material).
  10.  Blood can now flow freely through the artery to the brain.

Note, a different technique, called an eversion carotid endarterectomy, may be used. This procedure involves turning the carotid artery inside out, removing the plaque, then reattaching the artery.

The entire procedure takes approximately two hours. After your procedure is over, your surgeon may perform an imaging test (such as an angiogram) to ensure that the artery is open and that the surgery was successful.

After the Surgery

After surgery, you will go to the recovery area, where you will be closely monitored.

For a major procedure, you may recover in the hospital, possibly in the intensive care unit (ICU), for several days. 

If you are having a procedure that is considered minor, such as a venous ligation and stripping procedure, it will likely be done on an outpatient basis. In this instance, you would not be transferred to the ICU, nor would you have an overnight stay in the hospital. If there are no complications, you might be discharged to your home on the day of surgery after a minor vascular surgical procedure.

Postoperative Period and Follow-up

Many vascular conditions, such as those caused by atherosclerosis, are considered chronic. In this instance, you might need to continue to follow up with your vascular surgeon.

Initial follow-up care after carotid endarterectomy is recommended within the first 3 months after surgery. Regular checkups—every two years—are recommended on a long-term basis.

A Word From VeryWell

Proper preparation for surgery helps set you up for a quicker recovery. Make sure to follow all instructions from your healthcare team and have all important documents with you on the day of the surgery. It's also helpful to bring a loved one with you to help keep things in order. Having a companion can also help relieve some of the stress associated with having a surgical procedure.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. University of Iowa Hospitals & Clinics. Use Hibiclens soap to help prevent surgical site infections.

  2. MedlinePlus. Carotid artery surgery.

  3. Yale Medicine. Vascular surgery.

  4. Society for Vascular Surgery (SVS). New follow-up guidelines for imaging after vascular surgery announced by SVS.

By Sherry Christiansen
Sherry Christiansen is a medical writer with a healthcare background. She has worked in the hospital setting and collaborated on Alzheimer's research.