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The blood supply to the common carotid artery starts at the arch of the aorta (left) or the subclavian artery (right). The common carotid artery divides into the internal carotid artery and the external carotid artery. Plaque often builds up at that division, and a carotid endarterectomy cuts open the artery and removes the plaque.
Atherosclerotic plaque from a carotid endarterectomy specimen. An endarterectomy of the carotid artery in the neck is recommended to reduce the risk of stroke when the carotid artery is severely narrowed, particularly after a stroke to reduce the risk of additional strokes. [citation needed]
Conversely, the outer, older portions of the plaque become more calcified, less metabolically active and more physically stiff over time. [citation needed] Veins do not develop atheromata, because they are not subjected to the same haemodynamic pressure that arteries are, unless surgically moved to function as an artery, as in bypass surgery ...
The most common of cerebrovascular conditions treated by vascular surgeons is carotid artery stenosis which is a narrowing of the carotid arteries and may be either clinically symptomatic or asymptomatic (silent). Carotid artery stenosis is caused by atherosclerosis whereby the buildup of atheromatous plaque inside the artery causes narrowing.
Atherosclerosis causes plaque to form within the carotid artery walls, usually at the fork where the common carotid artery divides into the internal and external carotid artery. The plaque build-up can narrow or constrict the artery lumen, a condition called stenosis. Rupture of the plaque can release atherosclerotic debris or blood clots into ...
Carotid artery stenosis can be treated with angioplasty and carotid stenting for patients at high risk for undergoing carotid endarterectomy. [11] Although carotid endarterectomy is typically preferred over carotid artery stenting, stenting is indicated in select patients with radiation-induced stenosis or a carotid lesion not suitable for surgery.