Carotid endarterectomy Carotid endarterectomy Carotid endarterectomy (CEA) is a surgical procedure performed by vascular surgeons used to reduce the risk of stroke by correcting stenosis (narrowing) in the common carotid artery or internal carotid artery. Endarterectomy is the removal of material on the inside ("end(o)-") of an artery. 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 cause the formation of a blood clot
Carotid endarterectomy (CTA) or invasive angiography. Revascularization of symptomatic stenoses has a much higher therapeutic index compared to asymptomatic lesions. The North American Symptomatic Carotid Endarterectomy Trial (NASCET) and the European Carotid Surgery Trial (ECST) are both large randomized class 1 studies which have helped define current indications for carotid endarterectomy in symptomatic patients. The NASCET found that for every six patients treated, one major stroke would be prevented at two years (i.e. a number needed to treat (NNT) of six) for symptomatic patients with a 70–99% stenosis, where percent stenosis was defined as: Symptomatic patients with less severe carotid occlusion (50–69%)