Carotid Endarterectomy


A carotid endarterectomy (CEA) is a surgical procedure that removes plaque from your carotid arteries, which are located on each side of your neck and supply oxygenated blood to your brain. When plaque builds up inside your carotid arteries, it causes them to harden and narrow. This limits blood flow to your brain, which increases your risk of a stroke or a transient ischemic attack (TIA), also known as a mini-stroke. A piece of plaque may also break away and travel up to the brain causing a blockage or stroke. A CEA removes the plaque from the carotid artery and restores normal blood flow to your brain, reducing your stroke risk.


Before your CEA, your doctor may request one or more of the following tests to determine the extent of your carotid artery disease:

  • Carotid angiography – uses a catheter, contrast dye and X-rays to show where the carotid artery has narrowed.
  • CT scan (or CTA) – uses X-rays to take pictures of the carotid arteries from many angles and produces a multi-dimensional image.
  • Carotid Doppler ultrasound – uses sound waves to show the speed and direction of blood flow through the carotid arteries and creates an image of the inside of the artery.
  • Magnetic resonance imaging (MRI or MRA) – uses a large magnet and radio waves to create pictures of the carotid arteries. Contrast dye may be used to improve visibility.

Like most surgeries, this one has potential risks. Specific CEA risks include a possible reaction to anesthesia, bleeding, infection or nerve injury that could cause numbness to your face or tongue. Although rare, serious complications such as a stroke or death could occur.

Factors that increase CEA complications include being female, older than 75, or having diabetes or another serious medical condition.

What to Expect

Your surgeon will make an incision in your neck and remove the plaque that has built up in the carotid artery. The procedure typically lasts 2 hours.

Most people receive general anesthesia, which temporarily puts you to sleep. You will be fully monitored with a blood pressure cuff, heart monitor and pulse oximeter (to measure oxygen levels in your blood). You’ll also receive oxygen and IVs. If you are unable to have general anesthesia, there are other ways to sedate you, which can be discussed with your surgeon.


After surgery, you may have a sore neck for a few days or some numbness to your chin. You can expect to recover in the hospital for a day or two after the procedure. Your doctor will prescribe pain medication to help make your recovery more comfortable. To reduce the risk of developing a blood clot, your doctor may prescribe aspirin and/or Plavix. 

Be sure to seek emergency care if you experience a severe headache, signs of a stroke or TIA, or swelling in the neck.

Your doctor will advise you on when you may resume your normal activities, including driving.

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