If you have a TIA and a scan shows a significant stenosis of the carotid artery then you are at risk of a major stroke (11% over 2 years).  Careful studies have shown that this risk can be reduced to 6% by surgery.  The operation is called a CAROTID ENDARTERECTOMY.  The disease in the artery is removed restoring a smooth surface and so preventing further clots (emboli).

 The procedure involves a cut in the neck, takes 2 hours on average to perform, and usually necessitates 1-2 days in hospital. It is possible to have the operation done under local or general anaesthesia. The major risk of the operation is that it will cause a stroke. This occurs in only 2-3% of cases and strenuous efforts are made to prevent this by careful surgery and monitoring. Despite the risk of the operation the overall benefit favours surgery if there is a significant stenosis.  Other more minor complications include numbness around the wound, and disturbance of nerves to the tongue and throat.  There are no age limits for the operation providing there is no other severe medical problems such as heart disease.

 During this procedure a monitor can be used to show the blood flow to the brain. This is one method used to try and keep the risk of stroke from the procedure as low as possible. The current national results show this occurs in only 2-3% of procedures on average.

For further information on carotid endarterectomy visit the section at the Circulation Foundation