What surgeries are done for carotid stenosis?

Open vs. Endo: The two procedures done for carotid stenosis are 1) carotid endarterectomy: exposing, opening, and cleaning out the plaque / atherosclerosis from the diseased artery followed by closing the artery with a patch to prevent it from scarring down. Time honored procedure 2) carotid stenting: using wires, catheters and balloons to get to and stent the diseased artery. This is done from the groin.

Endarterectomy: Endarterectomy is the most common, done with a small incision in the neck and the carotid artery plaque is removed and the artery is sewn back up with a patch to keep it from narrowing. The second more recent treatment is carotid stenting which is usually done through the femoral artery with catheters and guide wires. Both procedures have risks and should only be done for severe disease.

Depends on %: If less then 50% nothing. Follow w ulttrasound yearly, asa 81 and statin(regardless of chol level), stop smoking. >50% and symptomatic, then a carotid endarterectomy. Stents are not as good yet 2% stroke vs 6-10% stroke >75% and asymptomatic carotid endarterectomy.

Two: Different choices. Stent or endarterectomy.

Endarterectomy: Most patients undergo an endarterectomy where the plaque is surgically removed. Carotid stenting is also done less frequently when needed. In very, very rare cases, a bypass is needed. The vast majority of carotid disease is best treated medically