What is endarterectomy?

Endarterectomy is surgery to remove plaque that is blocking blood flow in an artery. Plaque is a combination of cholesterol and other materials that build up on the inside of blood vessels and cause narrowing or blockages. Plaque can occur in any blood vessel in the body. When the plaque buildup is severe and it blocks blood from flowing through blood vessels, it can cause organ damage or other life threatening conditions. When this condition occurs in the main arteries in the neck that bring oxygen rich blood to the brain (called the carotid arteries), it can cause a stroke.

How is endarterectomy done?

Before the procedure:

• Your healthcare provider will ask you to sign a consent form for an endarterectomy. The consent form will state the reason you are having the procedure, what happens during the procedure, and what you may expect afterward.
• Tell your healthcare provider if you are allergic to any medicines.
• Tell your healthcare provider if you are taking any medicines, including nonprescription drugs, herbal remedies, or illegal drugs (if any).
• You will have a small tube (IV catheter) inserted into a vein in your hand or arm. This will allow medicine to be given directly into your blood and to give you fluids, if needed.

During the procedure:

• You may be given a sedative through your IV to help you to relax.
• You will be given medicines to prevent pain during your surgery. This is usually done with general anesthesia, which relaxes your muscles and you will be sleep. A breathing tube is usually put in your throat when you have general anesthesia.
• You may have a small tube (catheter) placed into your bladder through the urethra (the opening from the bladder to the outside of the body) to drain and measure urine from the bladder.
• The surgeon will make a cut in the area over the artery with the plaque blockage.
• A cut will be made in the artery and the plaque will be removed from the lining of the artery.
• The artery will be stitched closed and then the skin will be stitched closed.

After the procedure:

• You will be checked often by nursing staff.
• There will be a dressing on the incision. The dressing will be checked and changed by your provider or the nursing staff as needed.
• Your provider may prescribe medicine to:
  • Treat pain
  • Treat or prevent an infection
  • Relax and widen blood vessels and allow blood to flow through them easier
  • Help prevent blood clots
  • Control cholesterol levels
• Your blood oxygen level will be monitored by a sensor that is attached to your finger or earlobe.
• A cardiac (heart) monitor will be used to keep track of your heart rate and rhythm.

What can I do to help?

• You will need to tell your healthcare team if you have new or worsening:
  • Chest pain or pressure, squeezing, or fullness in the center of your chest that lasts more than a few minutes, or goes away and comes back (may feel like indigestion or heartburn)
  • Pain or discomfort in one or both arms or shoulders, or in your back, neck, jaw, or stomach
  • Trouble breathing
  • Breaking out in a cold sweat for no known reason
  • Along with the previous symptoms, feeling very tired, faint, or sick to your stomach
  • Anxiety
  • Unusual bleeding or bruising or bleeding that does not stop
  • Bluish color of the skin on your leg or toes
  • Dizziness or lightheadedness
  • Feeling like your heart is beating too fast, too slow, or skipping beats
  • Increased pain at the site of surgery
  • Weakness, numbness, tingling or pain in your face, arm, or leg, especially on one side of your body
• Ask questions about any medicine, treatment, or information that you do not understand.

How long will I be in the hospital?

How long you stay in the hospital depends on many factors. The average amount of time to stay in the hospital after an endarterectomy is 1 to 3 days.