What is an endarterectomy for atherosclerosis/PAD/PVD?
An atherosclerosis endarterectomy is the open surgical removal of plaque from a blood vessel.
Why is this procedure performed? Why do I need this procedure?
The goal of treatment is to eliminate the build-up of plaque in your arteries.
You may need this atherosclerosis endarterectomy procedure if your arteries become too narrowed or blocked from plaque inside the artery walls. If arteries are blocked, blood cannot get through to nourish the tissues, causing the muscles of the lower extremities to cramp and lose strength. In severe cases, you may experience pain at rest or develop ulcers on your feet.
Each patient is evaluated, and treatment will be individualized for the patient's circumstances.
Where is the procedure performed and who performs this procedure?
This atherosclerosis endarterectomy procedure is performed in the hospital surgical suite by a vascular surgeon.
What are the risks and potential complications of the procedure?
Your doctor will discuss the specific risks and potential benefits of the recommended procedure with you.
Endarterectomy usually has no complications, but as with any surgery, there is a risk of complications. An unusual complication is the re-blockage of the artery (restenosis) that may occur later, especially if you smoke cigarettes.
Special precautions are taken to decrease these risks, and there may be other possible risks. When you meet with your doctor, please ask questions to make sure you understand the risks of the atherosclerosis endarterectomy procedure and why the procedure is recommended.
How do I prepare for the procedure?
A few days before the procedure, pre-procedure tests may be performed to ensure that it is safe to continue with the procedure. You may need to discontinue certain medications before the atherosclerosis endarterectomy procedure. Your health care team will provide specific instructions to help you prepare.
What happens during the procedure?
The endarterectomy will be performed under general anesthesia or regional anesthesia (such as an epidural catheter or nerve block). The surgeon will make an incision at the site of the blockage. He/she may insert a shunt (tube) into the artery above and below the atherosclerotic plaque in order to temporarily reroute blood flow around the blockage or narrowing and isolate the area. The surgeon then makes a length-wise incision along the portion of the artery containing the plaque. The plaque is removed using an endarterectomy spatula, and in some cases, the diseased portions of the vessel are also removed. When the plaque removal is complete, the surgeon stitches the vessel closed and then removes the shunt. In many instances, the artery is closed with a patch that is made out of the patient's own vein or a man-made synthetic material. Blood flow is restored through its normal path.
How long does the procedure last?
The procedure itself generally takes two to three hours, but the preparation and recovery time add several hours. The surgery may require a minimum hospital stay of one to two days.
What happens after the procedure?
You can usually begin normal activities again several weeks after the operation. Your doctor will provide specific guidelines for your recovery.
Are there any side effects of the treatment?
There are few side effects from this procedure, but some patients may experience some mild skin numbness in the area around the incision.
Results of the atherosclerosis endarterectomy procedure
Endarterectomy usually provides good relief of symptoms. Your doctor will discuss the results of the procedure with you. However, unless a healthy lifestyle is adopted, atherosclerosis can recur.
How do I find out if I am a candidate for this procedure?
To find out if you are a candidate for this procedure, please call the Vascular Surgery Department at 216.444.4508 or 800.223.2273 ext. 44508.