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Carotid Endarterectomy
Background
Carotid endarterectomy (CEA) is a surgical procedure that involves the removal of plaque from the carotid arteries. Carotid arteries are the two major arteries located in the neck, which branch off from the aorta and supply blood to the brain. Plaque formation in the carotid arteries can result in stroke or transient ischemic attack (TIA). This extracranial atherosclerosis, or blockage in the arteries that supply blood to the brain, accounts for 15%–20% of all ischemic strokes. All patients presenting to the hospital with ischemic stroke or TIA should be worked up for carotid artery disease. Patients with carotid artery stenosis of ≥70% can be considered for CEA for prevention of future stroke.
How to Use It
All patients admitted to the hospital for ischemic stroke or TIA workup should be screened for carotid artery stenosis via carotid duplex ultrasonography, a noninvasive and sensitive method for detecting the disease. Patients with carotid artery blockage of ≥70% can benefit from CEA for prevention of future strokes, especially patients presenting with TIA. Prior to CEA, carotid artery stenosis should be correlated by at least one additional imaging resource such as magnetic resonance angiography (MRA) or computed tomography (CT) angiography. Asymptomatic patients can be screened for carotid artery stenosis by auscultating the carotid arteries. Presence of carotid bruits during physical examination should prompt further workup for carotid artery disease.
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