Carotid artery plaque is the leading cause of ischemic (nonhemorrhagic) stroke. There are approximately 500,00 strokes each year in the United States and 30-40% of those patients die of complications related to the stroke.

A few patients may have warning symptoms before a stroke, usually caused by particles of plaque or clot breaking off and traveling to the brain or eye. These symptoms may include unilateral weakness, paralysis of numbness of the face or limbs, difficulty speaking, or unilateral visual symptoms. If the symptoms are temporary (less than 24 hours) the term transient ischemic attack (TIA) may be used. Some patients call these events "mini stokes". Unfortunately, most stoke victims have no warning symptoms prior to the stroke. Carotid artery stenosis (blockage) is generally not a cause of dizziness, memory loss or fainting.

Many strokes can be prevented by surgery called carotid endarterectomy which consists of removing plaque from the diseased artery. Surgery will not correct a stroke after is occurs. The risk of stroke appears to increase as the degree of stenosis increases. Studies have shown that patients who have had prior strokes of TIAs have a particularly high risk of stroke in the near future and may benefit from carotid endarterectomy. Even patients with no prior symptoms, who have stenosis of 60% or more, may benefit from surgery depending on the individual's age and medical condition.

During surgery, an incision is made over the carotid artery which is located on the side of the neck. Often, a shunt (a type of special plastic tube made for this purpose) is inserted in the artery to continue blood flow to the brain. The plaque is removed using delicate instruments. The artery is then closed, most often with a patch that can be made of artificial or natural materials such as Dacron or a piece of vein. After surgery, the patient is usually monitored closely for a few hours and most go home the following day.

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The content on this web site is intended to provide you and your family with a better understanding of cardiothoracic and vascular surgery including coronary artery disease, beating heart bypass surgery and endoscopic vein harvesting. This information is not intended as a substitute for an informed discussion with your physician.  We encourage you to maintain an open dialogue with you and your primary care physician.  Please feel free to print the information contained on this web site and share this information with your family and physician(s).

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Last Updated: Tuesday, November 20, 2001 Rev A

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