What is an endarterectomy?
Endarterectomy is a surgical procedure to remove plaque from the arteries. A special tool is used to clean the buildup of fatty plaque deposits that stick to the arterial wall, causing blockages and reduced blood flow. Once cleared away, the plaque rarely accumulates enough to cause issues again.
There are many different types of endarterectomies, each associated with the location of the affected artery:
- Carotid endarterectomy: Cleans up the left and right carotid arteries that run through your neck to your brain.
- Femoral endarterectomy: Removes fatty buildup from the femoral artery, the large blood vessel that travels down your legs to your lower body.
- Aortic endarterectomy: Clears blockages from the aorta, the largest artery in your body, which pumps blood from your heart to the rest of the body.
- Coronary endarterectomy: Treats blockages or narrowing of the coronary artery, which is responsible for circulating blood back to your heart.
- Pulmonary endarterectomy: Removes old blood clots or other buildups in the pulmonary arteries inside your lungs.
Who needs to get an endarterectomy?
Endarterectomies are used to treat all kinds of arterial diseases and atherosclerosis — both terms that mean there’s a blockage, narrowing or buildup inside an artery.
While the end result (improved blood flow) is the same, it’s different from carotid stenting in that it clears out the plaque narrowing or blocking an artery instead of opening up the vessel with a stent.
An endarterectomy is a surgery, so it’s not recommended for all patients. The severity of your arterial disease and overall health dictate whether it’s right for you. It may not be a viable option if you have a condition that makes surgery dangerous, like:
- Heart problems, including recent heart attacks or congestive heart failure
- Respiratory issues like COPD or emphysema
- Damage to the artery from radiation, infection, blood clots or calcification
What are the potential complications of an endarterectomy?
Risks are low for those able to undergo an endarterectomy. Your individual risk depends on the location of the surgery and the level of buildup inside your artery. Bleeding, infection and temporary nerve damage may occur. Although rare, heart attack, stroke and a re-narrowing of the artery is also possible.
How do you prep for an endarterectomy procedure?
Much of the preparation for an endarterectomy involves testing to evaluate the location and severity of the arterial blockage. You may receive an angiography or angiogram to capture images of your arteries or an ultrasound to check out your blood flow.
Your vascular team will also run you through tests to evaluate your fitness for surgery. Stress tests, echocardiograms and other heart exams are used to measure your cardiovascular health.
Once cleared for this surgical procedure, you’re typically required to fast since you’ll be under anesthesia. You may also have to stop taking any current medications — or start new ones — help prep your body for surgery and reduce the risk of complications and drug interactions.
What should I expect after my endarterectomy?
If you were experiencing pain due to your poor blood flow, it will be gone following surgery. The biggest benefit of an endarterectomy vs. carotid stenting is that it restores your artery back to normal. Arterial blockages build up gradually over time, so the results of the surgery can last for many years.
The timetable for recovery is about a month. After a follow-up visit with your vascular team, you should be able to return to work and normal activity. For more strenuous activities or jobs, it can take up to two months before you’re able to return.