Carotid Endarterectomy

What is Carotid Endartectomy?

Carotid Endartectomy is a surgical procedure that removes atherosclerotic disease (or plaque) from a blood vessel in the neck called the Internal Carotid Artery – the main blood vessel that supplies the brain. The main aim of the operation is to remove the likely source of solid emboli that have been causing, or may cause the person to have a stroke.

What is the role of Ultrasound?

Vascular Ultrasound uses grey-scale images, colour-coded blood flow information and Doppler measurements to analyse how fast blood is flowing through a blood vessel. When a vessel has a significant narrowing, blood velocity measurements are taken to quantify how fast it is going and estimates are made as to how narrowed the vessel has become.

This information is passed on to the Vascular Surgeon along with measurements that give the size of the stenosis, the type of plaque and whether the vessel after the stenosis is patent or not. On the day of their carotid endarterectomy, the patient has another Ultrasound scan to confirm disease and the bifurcation of the main carotid artery is marked on the neck which gives the surgeon information on the location of their incision.

Why use Ultrasound?

Ultrasound gives real-time information on how blood flows through vessels and through areas of disease, which other imaging modalities do not. It also gives the surgeon valuable information on the type of plaque that is causing the disease, and how irregular it is, both factors which can estimate the stability of the plaque, and therefore the chance of it moving towards the brain.

Ultrasound does not involve radiation, ionisation or contrast agents and is considered significantly less hazardous than modalities which involve these issues. Ultrasound scans can easily be repeated with no hazard to the patient.

Post-Procedure Ultrasound

After the procedure, Ultrasound scans can be performed to monitor the patency of the vessel after the disease has been removed, or to monitor possible significant disease in the contralateral internal carotid artery.

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