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Patient Instructions

You had carotid artery surgery to restore proper blood flow to your brain. Your surgeon made an incision in your neck over your carotid artery. A tube was put in place for blood to flow around the blocked area during your surgery. Your surgeon opened your carotid artery and carefully removed plaque from inside it. The surgeon may have placed a stent (a wire mesh tube) in this area to help keep the artery open. Your artery was closed up with stitches after the plaque was removed.

During your surgery, your heart and brain activity were monitored closely.

You should be able to do most of your normal activities within 3 to 4 weeks. You may have a slight neck ache for about 2 weeks.

You may start doing everyday activities as soon as you are able. You may need help with meals, taking care of the house, and shopping at first.

Do not drive until your incision (cut) is healed, and you can turn your head without discomfort.

You may have some numbness along your jaw and near your earlobe. This is from your cut. Most of the time, this goes away in 6 to 12 months.

Do not wear turtlenecks or other clothes around your neck that rub against your cut.

• You may shower when you get home. It is okay if the tape (Steri-Strips) on your incision gets wet. Do NOT soak, scrub, or have the shower beat directly on the Steri-Strips. They will curl up and fall off on their own after about a week.
• Look carefully at your incision every day for any changes. Do not put lotion, cream, or herbal remedies on it without asking your doctor first if it is okay.

Having carotid artery surgery does not cure the cause of the blockage in your arteries. Your arteries may become narrow again. To prevent this:

• Eat a heart-healthy diet, exercise (if your doctor advises you to), stop smoking (if you smoke), and reduce your stress level. Doing these things will help lower your chances of having a blocked artery again.
• Your doctor may give you medicine to help lower your cholesterol. See also: Cholesterol - drug treatment
• If you are taking medicines for high blood pressure or diabetes, take them as your doctor has asked you to.
• Your doctor may ask you to take aspirin or a medicine called clopidogrel (Plavix) when you go home. These medicines keep your blood from forming clots in your arteries or stent. Do not stop taking them without talking with your doctor first.

See also:

• Clopidogrel (Plavix)
• Aspirin and your heart

Call your doctor or nurse if:

• You have a headache, become confused, or have numbness or weakness in any part of your body.
• You have problems with your eyesight, or you cannot talk normally.
• You cannot move your tongue to the side of your mouth.
• You have trouble swallowing.
• You have chest pain, dizziness, or shortness of breath that does not go away with rest.
• You are coughing up blood or yellow or green mucus.
• You have chills or a fever over 101 °F or a fever that does not go away after you take acetaminophen (Tylenol).
• Your incision becomes red or painful, or yellow or green discharge is draining from it.
• Your legs are swelling.

Carotid endarterectomy - discharge; CEA - discharge; Angioplasty - carotid artery - discharge; Percutaneous transluminal angioplasty - carotid artery - discharge; PTA - carotid artery - discharge

Chaturvedi S, Bruno A, Feasby T, Holloway R, Benavente O, Cohen SN, et al. Carotid endarterectomy -- an evidence-based review: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2005;65:794–801.

Goldstein LB. Prevention and management of stroke. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Libby: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Saunders;2007:chap 58.

Mas JL, Chatellier G, Beyssen B, Branchereau A, Moulin T, Becquemin JP, et al. Endarterectomy versus stenting in patients with symptomatic severe carotidstenosis. N Engl J Med. 2006 Oct 19;355(16):1660-71.

Eckstein HH, Ringleb P, Allenberg JR, et al. Results of the Stent-Protected Angioplasty versus Carotid Endarterectomy (SPACE) study to treat symptomatic stenoses at 2 years: a multinational, prospective, randomised trial. Lancet Neurol. 2008 Oct;7(10):893-902. Epub 2008 Sep 5.

Updated by: Larry A. Weinrauch MD, Assistant Professor of Medicine, Harvard Medical School, Cardiovascular Disease and Clinical Outcomes Research, Watertown, MA.. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.