The carotid endarterectomy serves to remove plaque buildup from those arteries that supply blood to the brain, neck, and face. When left untreated, this plaque causes the narrowing of the carotid arteries and can lead to the development of dangerous blood clots. If clots or plaque completely block the flow of blood to the brain, the patient may experience a fatal or permanently incapacitating ischemic stroke.
To prevent such an outcome, a surgeon exposes the carotid artery. He or she places a clamp on the artery to inhibit blood flow, at which point the patient's second carotid artery takes over the transmission of blood. If this is not possible, the surgeon may temporarily reroute blood flow through a shunt.
After blood flow through the blocked artery has stopped, the surgeon opens the artery and removes the plaque deposit as well as the inner arterial lining to which it attaches. In some cases, the patient may require a vein graft to widen the treated artery. This graft often comes from the patient's leg, although patient circumstances may indicate the use of a synthetic graft. After the graft is complete, the surgeon removes the shunt and closes incisions so that the patient may begin the recovery process.