Transient ischemic attack; TIA
Carotid endarterectomy is a surgical procedure that cleans out plaque and opens up the narrowed carotid arteries in the neck. It is recommended to prevent ischemic stroke in some patients who have carotid artery stenosis of 70% or more. For people whose carotid arteries are narrowed by 50% or less, anti-clotting medications (antiplatelets and anticoagulants) are usually recommended in place of surgery. For patients with moderate stenosis (50 - 69%), the decision to perform surgery needs to be determined on an individual basis.
There is a risk of a heart attack or stroke from the procedure. Anyone undergoing this procedure should be sure their surgeon is experienced in performing this procedure and that the medical center has complication rates of less than 6%. Carotid endarterectomy is generally not recommended for patients with acute stroke.
Procedure Description. A carotid endarterectomy involves:
Carotid angioplasty and stenting (CAS) may be used as an alternative to carotid endarterectomy for some patients It is based on the same principles as angiography done for heart disease.
This procedure carries a risk for an embolic stroke and other complications. At this time, it is being used in some centers as an alternative to endarterectomy in patients who cannot undergo endarterectomy, especially for patients with severe stenosis (blockage greater than 70%) and high surgical risk.
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