Health Library







Categories > Stroke >

Operation stroke prevention
What’s involved


Who benefits most?
Who benefits most?

Studies have found that certain people are more likely to benefit from carotid endarterectomy. These include people who:

  • have already had a stroke or a transient ischemic attack (TIA, or mini-stroke)
  • have 70 percent or more blockage of the carotid arteries

Other stroke prevention options may be a better choice for those who:

  • are female
  • have congestive heart failure
  • are older than age 75
  • have a blocked leg or arm artery (a condition called peripheral vascular disease)
  • have systolic blood pressure above 180 mm Hg (systolic blood pressure is represented by the top number in blood pressure readings)

Did you know a surgical procedure can help prevent stroke in people at high risk? The operation, called carotid endarterectomy, involves unclogging the blocked neck arteries that can lead to stroke—an acute brain attack that strikes 780,000 Americans a year.

What’s involved

A stroke occurs when blood flow to the brain is blocked. Plaque buildup in one of the carotid arteries—the arteries that run from the neck to the brain—is one reason for this reduced blood flow. In an endarterectomy, a surgeon makes an incision to open the artery, removes the plaque and then closes the artery. While the surgery can reduce some people’s two-year risk of stroke by more than 80 percent, in certain patients, the complex surgery actually has been known to trigger a postoperative stroke.

Fortunately, by studying endarterectomy patients, doctors have been able to determine why the procedure is successful in certain situations and not in others. The guidelines they developed are found in the box below.

For people who are not candidates for endarterectomy, stents can help. Doctors may be able to insert the tiny scaffold-like device into the blocked carotid artery to prop it open. The stenting procedure works best on those who have had a previous endarterectomy or who have significant blockages in both carotid arteries.