Carotid Endarterectomy
Carotid endarterectomy is surgery to remove the fatty plaque narrowing a carotid artery — the main vessel in the neck supplying the brain. It is used to lower the risk of stroke in carotid artery disease, particularly after a warning stroke or transient ischemic attack (TIA), by clearing the blockage and restoring smooth blood flow to the brain.
Medically reviewed by the Florence Healthcare medical team · Last reviewed June 2026
Overview
The carotid arteries in the neck carry blood to the brain, and over time fatty deposits (plaque) can build up and narrow them — carotid artery disease. This narrowing can cause a stroke, either by severely restricting flow or, more often, by shedding fragments that travel to the brain. Carotid endarterectomy treats this by opening the artery and carefully removing the plaque lining, then closing the vessel, usually with a patch, to restore a smooth, wide channel. It is a long-established vascular operation and, in suitable patients, is highly effective at reducing the risk of a future stroke. For some patients a stent placed inside the artery may be an alternative, which the team weighs individually.
The decision rests on the degree of narrowing, whether you have already had stroke-like symptoms, and your overall health. For patients travelling from abroad, a dedicated coordinator arranges appointments, a clear treatment plan and a transparent cost estimate before travel, including the expected length of stay, and our vascular and cardiology teams can review your scans (ultrasound, CT or MR angiography) and reports remotely first, so surgical and stenting options are weighed together before you decide to travel.
Who is a candidate?
- People with significant carotid narrowing who have had a stroke or TIA (a “mini-stroke”) on that side
- Patients with symptoms such as temporary loss of vision, weakness or speech difficulty linked to the narrowed artery
- Selected people with severe narrowing found on a scan even without symptoms, after careful assessment
- Patients whose narrowing is confirmed and graded on ultrasound, CT or MR angiography
- Those fit enough for surgery, in whom the benefit of preventing stroke outweighs the operative risk
- People for whom the team judges open surgery preferable to a carotid stent
What happens
- 1
Assessment and planning
Carotid ultrasound and, where needed, CT or MR angiography grade the narrowing, while your heart and general health are assessed. Imaging and reports can be reviewed remotely, and surgery versus stenting weighed, before travel.
- 2
Preparation
Your team optimizes blood pressure, controls risk factors and reviews your medication, including blood thinners. The anesthetic — general or local — is planned, and the operation and recovery explained.
- 3
The operation
Through an incision in the neck, the surgeon opens the carotid artery, carefully removes the plaque lining and closes the vessel, usually with a patch to keep it wide. Blood flow to the brain is protected throughout, sometimes with a temporary shunt.
- 4
Early recovery
You are monitored closely, particularly your blood pressure and neurological signs, usually for one to two days. The neck wound is checked, and you are guided on caring for it and on resuming activity.
- 5
Recovery and prevention
Most people return to normal activity within a few weeks. Continuing medication and managing risk factors — blood pressure, cholesterol, diabetes and not smoking — protect the result. International patients receive a clear plan and can be supported remotely after returning home.
Benefits
- Substantially lowers the risk of a future stroke in suitable patients
- Directly removes the plaque and the source of clot fragments travelling to the brain
- Particularly valuable after a warning stroke or TIA, when stroke risk is highest
- A long-established operation with well-understood results
- Restores smooth, unobstructed blood flow to the brain through the treated artery
- Can often be performed under local anesthesia in selected patients
Risks & considerations
- A small risk of stroke during or soon after the operation, which the team works to minimize
- Bleeding, or a collection of blood (haematoma) in the neck
- Temporary or, rarely, lasting injury to nearby nerves, affecting voice, swallowing or facial movement
- Wound infection or numbness around the scar
- Heart strain in patients with coexisting heart disease, monitored closely afterwards
- Re-narrowing of the artery over time in a minority of patients
Where it is performed
This procedure is delivered by our Heart Center.
Learn more before you decide
Provider-reviewed guides on the related conditions, symptoms and tests in our Health Library.
Carotid Endarterectomy — frequently asked questions
A narrowed carotid artery can cause a stroke with little or no warning, especially after a TIA or minor stroke. Surgery is recommended when the assessed risk of a future stroke is high enough that removing the plaque clearly outweighs the operative risk. Where narrowing is found without symptoms, the team weighs the decision carefully with you.
Endarterectomy removes the plaque through an open operation, while stenting props the artery open from inside using a small mesh tube via a catheter. Both aim to prevent stroke; the better option depends on the anatomy of the narrowing, your age and your overall health. Our vascular and cardiology teams advise which suits you after reviewing your scans.
Most patients stay about one to two days for close monitoring and return to normal activity within two to four weeks, with the neck wound healing over that time. Continuing your medication and controlling risk factors such as blood pressure, cholesterol and smoking is essential to protect the result long term.
Carotid endarterectomy usually means about one to two days in hospital plus a short period locally before travelling home, and your coordinator confirms the timeline. We provide a transparent, itemized cost estimate after reviewing your case — covering assessment, surgery, hospital stay and follow-up — rather than quoting fixed prices online, because each plan is individual.
Yes. Send your carotid ultrasound, CT or MR angiography and reports, and our vascular and cardiology teams give an independent opinion remotely on whether surgery or a stent is appropriate and how urgent it is, so medical and surgical options are weighed together before you travel.
No. Surgery treats the narrowing in the artery operated on, but the underlying process can affect other arteries, including the heart. That is why lifelong attention to blood pressure, cholesterol, diabetes and not smoking, alongside prescribed medication, is part of the treatment and is explained as part of your plan.
Related treatments
Considering carotid endarterectomy?
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