Endarterectomy
An Endarterectomy is an open surgical option to remove plaque from the arteries.
This option is offered to patients with severe stenosis of any artery in the body when endovascular procedures are not applicable. It is a proven procedure that our surgeons at BEVSA have been performing and teaching for decades.
https://capetownvascular.co.za/wp-content/uploads/patient_resources/05_Femoral_Endarterectomy.pdf
Who is eligible for an Endarterectomy?
An Endarterectomy can be done on any artery with severe stenosis or occlusion preventing adequate flow through the artery. The most common endarterectomies done by our office are the femoral endarterectomy and the carotid endarterectomy (CEA).
- Femoral Endarterectomy is done due to severe plaque build-up in the femoral artery causing severe stenosis or an occlusion of that artery. Your surgeon will try minimally invasive procedures which is done endovascularly prior to proceeding with an endarterectomy. However, if the artery is occluded, it will prevent entry into the artery with a catheter to treat any atherosclerosis in the legs. This procedure can be done individually or in conjunction with a minimally invasion procedure called an angiogram.
- Carotid Endarterectomy is done when the patient's carotid arteries are too tortuous for a stent to be placed and in carotid arteries that has already occluded. As it is extremely dangerous to reopen an occluded carotid artery as it may lead to a stroke. This does not apply to other arteries in the body. Additional facts may influence your surgeons decision.
- Other Endarterectomy, performed less commonly may include:
- Aortic and Iliac endarterectomy
- Popliteal endarterectomy
Procedure Details
The surgery begins by making a 3-4-inch incision down the side of the neck to expose the affected carotid artery or in the groin to expose the affected femoral artery. Next, the artery is clamped shut above and below the disease portion of the vessel. This prevents any blood from flowing into the diseased area as we open the artery and operate. After clamping the artery, we use forceps to carefully remove the plaque from the artery to ensure that it does not break off.
The procedure usually takes about 2 to 3 hours at Gates Vascular Institute under general anesthesia. Once all plaque is removed, a patch is sewn over the artery and the clamps are removed. This allows blood to flow through the now widely open artery which is free of plaque.
After the procedure, you are kept over night in the hospital for observations and is left with a 3-4inch incision which will take a couple of months to heal. For more information about an endarterectomy, you can discuss further with your surgeon.
Conditions Treatable with Endarterectomy
Peripheral Arterial Disease (PAD)
- Leg Pain While Walking
- Non-Healing Wounds
- Plaque in the Arteries