What are the surgical options for blocked carotid arteries?

Open vs. Stenting: The options are either an open carotid endarterectomy (neck incision with cleaning out of plaque) or carotid stenting (endovascular through a groin puncture). Currently stenting is reserved for people who have had neck radiation (scarring), previous neck surgery or active symptomatic heart disease (can't tolerate anesthesia). This widespread use of stenting is being hotly debated!

Endarterectomy: Endarterectomy is the most common, done with a small incision in the nect 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.

CEA: The gold standard for carotid stenosis is carotid endarterectomy.

Two options: If medical treatment fails- stent or surgery. Stent placed in vessel to open flow. Surgery cleans out vessel by removing plaque to improve flow.