(USMLE topics, neurovascular diseases)

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Voice by: Ashley Ottesen

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The carotid arteries are major blood vessels that provide blood supply to the head. There are two carotid arteries, one on each side of the neck. Each artery splits into 2 branches: the EXternal carotid arteries supplying the face, scalp and neck; and the INternal carotid arteries supplying the brain.
Carotid STENOSIS is a progressive NARROWING of carotid arteries caused by fatty deposits, or cholesterol plaques. Narrowed blood vessels RESTRICT blood flow to the brain. The plaques may also rupture, and blood clots may form, leading to a COMPLETE blockage. A stroke occurs when the blood supply to the brain is interrupted or seriously reduced.
Carotid endarterectomy is a surgical procedure performed to remove plaques from a carotid artery, with the goal of preventing strokes. This treatment is usually recommended for patients who have experienced symptoms of reduced blood flow, known as ministrokes or transient ischemic attacks, which are described as episodes of dizziness, numbness, confusion or paralysis.
In this procedure, an incision is made in the neck to access the artery. Clamps are used to temporarily stop blood flow through the affected segment. A small tube, called a shunt, may be used to reroute the blood flow to supply the brain during the procedure. An incision is made in the artery and the plaques are removed. At the end, the shunt is removed and incisions are closed.
Carotid endarterectomy can be effective in preventing future strokes but the procedure may not be suitable for everyone; the risks are generally higher in patients with overall poor health.