Carotid Artery Surgery

When you need it—and when you don’t

There are two large arteries in the front of the neck. They are the carotid arteries, and they take blood to the brain. If one is blocked, it can lead to a stroke.

The surgery to clear a blocked artery is called a carotid endarterectomy (CEA). If you have a blocked artery, you may wonder if you need a CEA.

But if you haven’t had symptoms, you should think twice about having CEA surgery. Here’s why:

Surgery usually isn’t needed if you don’t have symptoms.

If you have had a stroke or mini-stroke (TIA), the CEA surgery may help you avoid another stroke. The surgery is most likely to help if your arteries are very blocked.

But if you have not had a stroke or a mini-stroke, the benefit of surgery is small. There are better ways to reduce the risk of stroke, including lifestyle changes and new medicines. Discuss lifestyle changes and medicines with your doctor.

The surgery has serious risks.

CEA can have serious complications, including stroke, heart attack, and death. You are more likely to have complications if you are age 75 or older or if you have a serious medical condition, such as:

  • Diabetes
  • Severe heart or lung disease
  • Heart failure
  • An earlier heart attack

The surgery can cost a lot. 

This surgery may or may not be covered by your insurance.

When should you have carotid artery surgery?

A CEA is a good idea in these cases:

  • Your carotid artery is severely blocked and has already caused a stroke or mini-stroke. In this case, the surgery can greatly reduce your risk of another stroke.
  • You have moderate blockage but you have had a stroke or mini-stroke. A CEA may help if you have it soon after your stroke or mini-stroke.
  • You have severe blockage but you have not had a stroke or mini-stroke, you are 40 to 75 years old and your risk of complications from surgery is low.

If you should have surgery, make sure your surgeon has a low complication rate for people without symptoms. The rate should be less than 3 percent, and much lower is better.

This report is for you to use when talking with your health care provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.

© 2017 Consumer Reports. Developed in cooperation with the American Academy of Neurology.