An endarterectomy is a procedure to remove plaque buildup from narrowed or blocked arteries. It may be a treatment for peripheral artery disease or carotid artery disease. Your provider makes an incision over the blocked artery during the procedure. Then, they use a special tool to remove plaque.
An endarterectomy is a surgery to open narrowed or blocked arteries. Arteries are blood vessels that carry oxygenated blood throughout your body.
Your healthcare provider uses the procedure to remove plaque, a fatty and calcified substance that can build up in arteries. Providers use endarterectomies to improve blood flow and reduce your risk of blood clots or stroke.
The type of endarterectomy you have depends on where you have a blocked artery:
You may need an endarterectomy if you have atherosclerosis. Atherosclerosis is plaque buildup in an artery, eventually leading to stiff, narrowed arteries.
Usually, providers recommend an endarterectomy for moderate to severe atherosclerosis, especially if it causes symptoms. However, everyone’s situation is unique.
An endarterectomy is a treatment option for some people with peripheral artery disease (PAD). In PAD, plaque builds up in the arteries in your legs or arms. This blocks blood flow and may lead to pain, wounds and eventual death (gangrene) of your tissues.
You may also need an endarterectomy to treat carotid artery disease. In carotid artery disease, plaque builds up in your carotid arteries, the blood vessels that carry blood to your brain. Carotid artery narrowing can lead to a stroke or a transient ischemic attack (TIA) if you don’t get treatment.
Some people have risk factors that mean endarterectomy isn’t a suitable treatment option. You may not be a candidate for an endarterectomy if you have conditions that would make the surgery more dangerous, such as:
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Before an endarterectomy, you’ll likely have tests to evaluate the extent of the artery blockage, including:
You may also have tests to assess your overall heart health, such as an echocardiogram or stress test. Cardiovascular tests help your provider evaluate your heart attack risk and determine if you’re a good candidate for surgery.
Your provider gives you instructions to prepare for an endarterectomy. You may need to stop taking certain medications, such as blood thinners (anticoagulants), temporarily. In other cases, your provider may tell you to start taking medicines that inhibit platelets and clots, such as aspirin, for a period before the procedure.
You’ll need to fast before an endarterectomy. Your anesthesia team will tell you how long to fast before the operation.
You receive anesthesia so you don’t feel any pain during an endarterectomy. Your provider sometimes keeps you awake during a carotid endarterectomy to better monitor brain function.
During the procedure, your healthcare provider:
You may have a drainage tube extending from the incision site immediately after surgery to keep the area from bruising. Your provider will remove this before releasing you to go home. The hospital stay will depend on the type of surgery and location. For example, carotid endarterectomy patients are usually in the hospital for one day. Femoral endarterectomies, typically for two to four days and aortic endarterectomies, usually a week.
Endarterectomy removes the blockages and restores your artery back to its normal healthy size. The cleaned-out vessel can resolve leg pain with walking, help heal leg wounds due to poor circulation, resolve abdominal pain from poor circulation and significantly reduce your risk of stroke.
The results of an endarterectomy usually last for many years.
Endarterectomies are typically safe, but there’s a risk of complications such as:
In most people, the risk of serious complications is low and depends on the reason for the surgery and the location of the surgery. If your provider recommends an endarterectomy, it means that they believe the benefits of the procedure outweigh the potential risks.
Yes. Some factors can increase your risk of experiencing complications after an endarterectomy, including:
You have a follow-up visit with your healthcare provider about four weeks after the procedure. Your provider examines the incision and will image the repair over time with ultrasonography or CT scans. Most people can return to work after this follow-up visit.
Exercise can help recovery, but it’s important to avoid strenuous activity until your provider tells you it’s OK. You may need to wait one or two months to return to work if you have a job that requires manual labor or strenuous physical activity.
Call your healthcare provider right away if you experience any signs of complication after an endarterectomy, including:
A femoral endarterectomy is an open surgery, meaning it’s a major operation. You may stay in the hospital for several days, and recovery takes several weeks. But complications of a femoral endarterectomy are uncommon. Most people have long-lasting positive results.
An aortic and/or iliac endarterectomy is an open surgery, meaning it’s a major operation. You may stay in the hospital for several days, and recovery takes several weeks to months. But aortic and iliac endarterectomy are usually well tolerated with infrequent major complications. Most people have long-lasting positive results.
A carotid endarterectomy is an open surgery. You’ll most likely be in the hospital for one day, but recovery takes several weeks. However, complications of a carotid endarterectomy are uncommon. Most people have long-lasting positive results.
A note from Cleveland Clinic
An endarterectomy is a surgery to remove plaque from narrowed or blocked arteries. You may have an endarterectomy to treat peripheral artery disease or carotid artery disease. Your provider makes an incision directly over the blocked artery during the procedure. Then, they use a special tool to remove plaque. You usually stay in the hospital for one to two days, and recovery takes several weeks.
Last reviewed by a Cleveland Clinic medical professional on 08/29/2022.
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