Carotid Endarterectomy

Carotid endarterectomy is an operation to remove fatty plaque from the carotid artery in the neck, the main blood supply to the front of the brain. Plaque here can shed fragments that cause transient ischaemic attacks (TIAs) and strokes.

Its purpose is purely preventive: it lowers the risk of a future stroke and does not repair damage already done. The benefit is greatest when done within about 2 weeks of a TIA or minor stroke in an artery narrowed by 50 to 99 percent, and is much smaller in people without symptoms.

What Carotid Endarterectomy involves

An incision of 7 to 10 cm is made along the front edge of the neck muscle. The common, internal and external carotid arteries are exposed while protecting the nerves to the tongue, voice box and face. Heparin is given and the arteries are clamped. If monitoring shows the brain needs more flow, a temporary plastic shunt is placed to carry blood past the clamped section. The artery is opened lengthways, the plaque is peeled out of the wall in one piece and the far end is smoothed so no flap remains. Most surgeons close the artery with a patch to widen it; the eversion technique instead cuts the artery across, turns it inside out to remove plaque and rejoins it. Flow is checked with Doppler before the skin is closed over a small drain.

Who is a good candidate for Carotid Endarterectomy?

The decision balances your stroke risk on medication alone against the surgical team's own complication rate.

• A TIA, minor stroke or sudden loss of vision in one eye within the past 6 months with 70 to 99 percent narrowing on that side
• Symptomatic 50 to 69 percent narrowing, particularly in men and older patients
• Selected symptom-free people with 60 to 99 percent narrowing, higher-risk plaque features and a life expectancy over 5 years
• People who are functionally independent

It is usually not the right choice if:

• A completely blocked carotid artery, where surgery gives no benefit
• Near-occlusion, or narrowing under 50 percent
• A major disabling stroke with little function left to protect
• Previous neck radiotherapy, prior neck surgery or a very high lesion, where stenting is often preferred
• Severe unstable heart or lung disease

الخيارات التقنية

• Conventional endarterectomy with patch: The most widely used method; the patch reduces re-narrowing.
• Eversion endarterectomy: No patch needed; suits a looping, redundant artery.
• Local or regional anaesthesia: You stay awake so brain function can be checked directly during clamping.
• Selective or routine shunting: A temporary bypass during clamping, guided by stump pressure, EEG or oxygen monitoring.
• Carotid stenting or TCAR: Endovascular alternatives for hostile necks or high surgical risk.

ماذا يحدث خلال علاجك

The operation takes 1.5 to 2.5 hours under general or regional anaesthesia. Afterwards your blood pressure and neurological state are watched closely in a high-dependency area for several hours to overnight, and most people go home after 1 to 2 nights.

الإعداد لرحلتك

Plan for 7 to 10 days in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.

• Stop smoking and nicotine at least four weeks before and after surgery; it is the single biggest avoidable cause of wound problems
• Tell the team about every medicine and supplement you take; blood thinners, some herbal products and hormone treatment may need to be paused on your doctor's advice
• Arrange for someone to travel with you or to be reachable, and keep the first days at home free of work and lifting
• Book a changeable return flight; your surgeon confirms when you are fit to fly

التعافي والنتائج

Neck soreness, numbness along the jaw and ear lobe, and mild swallowing discomfort are common for a few weeks. Most people resume normal activity in 1 to 2 weeks and driving once neck movement is comfortable and any legal stroke-related restrictions have ended. Antiplatelet medicine and a statin continue for life, with blood pressure control and no smoking. A duplex ultrasound checks the artery at about 6 weeks and then periodically.

• Back to everyday activity: 1 to 2 weeks
• When results show: Stroke risk reduction begins immediately
• How long they last: Long-lasting; re-narrowing in under 10 percent

سياسة السلامة والمخاطر والتنقيح

The operation itself carries a small risk of the very event it aims to prevent.

• Stroke or death around the time of surgery: about 2 to 3 percent in symptom-free patients and 3 to 6 percent in symptomatic patients in good units
• Heart attack
• Injury to nerves controlling the tongue, voice, swallowing or lower lip, usually temporary
• Neck haematoma, which can compress the airway and need urgent return to theatre
• Hyperperfusion syndrome: severe headache, seizures or brain haemorrhage from a sudden increase in flow
• Re-narrowing of the artery over years
• Patch infection, rare

Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.

Cost of Carotid Endarterectomy in Türkiye

Clinic-Y does not publish a single price for Carotid Endarterectomy, because the honest figure depends on your case. What moves it:

• Anaesthetic type and intraoperative brain monitoring
• Patch material and shunt use
• High-dependency or intensive care nights
• Pre-operative duplex, CT or MR angiography and cardiac assessment

Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.

الأسئلة المتكررة