About carotid endarterectomy

A carotid endarterectomy is a type of surgery to treat a narrowing in your carotid artery. Your carotid artery is an artery in your neck that supplies blood to your brain. When there is a build-up of plaque (hardening of the artery), this narrows the artery and increases your risk of having a transient ischemic attack (TIA) or stroke. To decrease your risk of stroke, your surgeon makes an incision (cut) in your neck to remove the plaque and repair the artery.

carotid endarterectomy 
Before my carotid endarterectomy

Pre-Admission Visit

In the weeks before your operation, you will have a pre-admission appointment. This appointment could take 2 to 4 hours.

Pre-Admission Clinic at Toronto General Hospital
Eaton Building – Ground Floor, Room 400

What should I bring to my pre-admission appointment?

  • Your health card (OHIP card). If you do not have an OHIP card, please bring another form of government-issued photo ID, such as a driver's license or passport.
  • Any other insurance cards. You will need the policy number of your extended health insurance, if you have any.
  • Your spouse/partner, a trusted friend or family member (to offer you support and be a second set of ears).
  • All the medications you take in their original containers. This includes prescription medications, over-the-counter medicines, vitamins, supplements and herbal or natural products.
  • A copy of your power of attorney for personal care and/or advanced directives.
  • A list of any questions that you may have about the operation and recovery.
  • The name or phone number of your pharmacy, as well as any medical specialists that you have seen in the past 3 years.
  • If you have had a cardiac stress test, echocardiogram and/or a pulmonary function test in the past 3 years, it would be helpful to bring a copy of the final report with you to this appointment.

What happens during my pre-admission visit?

  • You will have blood tests and routine skin swabs. The swabs are taken from your nose and other areas of your body to check for germs that can cause infections.
  • You may also need an electrocardiogram (ECG) to check your heart and a chest x-ray to check your lungs.
  • You will meet many health care providers during your pre-admission visit. Please feel free to ask them any questions that you may have.
  • A pre-admission nurse will review your health history and give you information to prepare you for your operation, including directions for cleaning your skin, eating before your operation, taking your medications and pain management.
  • A pharmacist will review your medications.

Depending on your needs, you may also meet:

  • An anesthetist who will review your health history, discuss your anesthetic plan and pain relief after your operation.
  • A member of the medicine team, if you have other complex health problems.
Preparing for my carotid endarterectomy

The day before your surgery

  1. Do not eat or drink after midnight on the night before your operation.
  2. If you smoke, do not do so for 24 hours before your operation.
  3. Do not drink alcohol for 24 hours before your operation.
  4. Remove all nail polish and body piercings.

 Stop smoking before your surgery: learn how smoking and tobacco can affect your recovery after surgery, and how quitting can improve your health.

What Should I do the day of my surgery

Arrive 2 hours before your scheduled operation time.

Surgical Admission Unit (SAU) at Toronto General Hospital
Peter Munk Building – 2nd Floor
All hospital entrances are open by 6:00 am. However, Elizabeth St. and University Ave. are easiest to access.

After my carotid endarterectomy

After your surgery, you will go to the Vascular Step-Down Unit, located in the CVICU (Cardiovascular Intensive Care Unit) for 1 night.

What can I expect to have on my body?

You will be attached to some or all of these machines and tubes:

Incisions, tubes or drainsWhat to expect
thoracotomy illustration Incisions: Your surgery will be completed either by a thoracotomy or by video assisted surgery (VATS). With a thoracotomy, you will have an incision on your side: 8 to 25 centimetres (about 2½ to 10 inches) long. With VATS, you will have 3 to 5 small incisions on your side: each about 2 centimetres (about ¾ of an inch) long. You will also have 1 to 2 small incisions on your side for the chest tube(s): each will be about 2 centimetres (about ¾ of an inch) long.
stitches orstaples illustration Stitches or staples: You will have an incision (cut) in your neck about 10 to 15 cm long. Dissolvable stitches that will disappear over time are used to close this incision.
heart monitor illustration Heart monitor: You will be on a heart monitor while you are in the Step Down Unit.
IV illustration Intravenous (IV): You have an IV so we can give you fluids and medicines. It stays in until you are drinking well.
Back at home

You will continue to recover when you return home.

ActivityHow to manage at home
medication icon
  • As you become more active, you may have some pain. We will give you a prescription for pain medicine when you are discharged.
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  • You can expect to drink the evening after your operation and resume your regular diet the next day. It is normal to not feel hungry. Try to eat a little at each meal.
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  • Constipation is common when taking pain medication and reducing your activity. You may have an upset stomach.
  • Drink plenty of fluids unless otherwise told by your doctor.
  • If you have no other diet requirements or special needs, eat foods with more fibre.
  • If needed, take a mild laxative. If this does not help, visit your family doctor.
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  • If you have staples, your family doctor can remove them in 7 to 10 days. Your family doctor will follow your day-to-day recovery.
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  • Shower every day with mild soap. Pat the incision dry with a towel. Do not put lotions or cream on the incision until it is completely healed.
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  • You may feel tired after surgery. This is normal and may last several days.
  • Take a nap every day. Go to bed and get up at the same time each day. Increase your activity as you recover.
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  • You should expect to be off work for at least 4 weeks. Ask your surgeon when it’s safe for you to return to work.
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  • You may lift up to 10 pounds (5 kilograms) for the next month. Lifting more than 10 pounds may stress or tear the incision.
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  • You may drive a car in 3 to 4 weeks after you check with your family doctor.
Follow-up appointments

Where and when

About 1 week after your discharge, you will follow-up with your family doctor.

About 4 to 6 weeks after your operation, you will follow-up with your surgeon's office.

My contacts

Who do I call with general post-operative questions?

For non-emergency questions, call one of the Vascular Surgery Nurses below.

Sue DeVries, Nurse Practitioner
416 340 4266

Cindy Dickson, Vascular Clinic Nurse
416 340 3857

Please do not call these nurses to book appointments.

Call your surgeon's office:

Dr. John Byrne
Phone: 416 340 3996

Dr. Thomas Forbes
Phone: 416 340 3274

Dr. Kathryn Howe
Phone: 416 340 5193

Dr. Thomas Lindsay
Phone: 416 340 4620

Dr. George Oreopoulos
Phone: 416 340 3275

Dr. Graham Roche-Nagle
Phone: 416 340 5332

Dr. Barry Rubin
Phone: 416 340 3645

Who do I call if I experience complications

Go to the hospital nearest emergency room if you have:

  • Symptoms of a stroke (you suddenly can't see, you have trouble speaking, you can't move your hand, arm or leg or you lose consciousness.)
  • New neck swelling.
  • Difficulty breathing.
  • Difficulty swallowing.

Call your surgeon's office if you notice the following symptoms:

  • New headache.
  • Leaking from your incision.
  • Increasing redness, warmth and tenderness around your incision.
  • Chills or fever greater than 38.5℃

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