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Carotid Artery Surgery Carotid artery disease occurs when plaque accumulates inside the carotid artery. Plaque can accumulate in the walls of your arteries as you age. Plaque is made up of fibrin tissue, cholesterol, and calcium. When the plaque increases, your arteries narrow and become hardened. This is the definition of atherosclerosis, or hardening of the peripheral arteries. Eventually, enough plaque builds up to decrease blood flow through your carotid artery, or can cause some irregularities in the normally smooth inner walls of the arteries. Treatment: Endarterectomy: To help prevent infections, your neck will be shaved where the surgeon is going to make an incision. Your surgeon then creates an incision on one side of your neck to expose the carotid artery with the blockage.Next,the surgeon clamps the carotid artery to prevent bleeding. Then, your brain will be receiving blood from the non-operative carotid artery on the opposite side of your neck. If needed, the surgeon can place a shunt to reroute the blood while operating. After the carotid artery is clamped, the surgeon makes an incision directly into the blocked section. Next, your surgeon removes the plaque deposits by removing the inner-most lining of the diseased section of your artery. After the surgeon removes the plaque, stitches will be applied to your artery, and the clamps will be removed. The neck incision will be closed and the procedure is complete. A patch may be used to open the artery during the procedure. The procedure takes around 2 hours to perform but it may seem longer depending upon the type anesthetic and preparation time. Stent: Carotid artery stenting is a procedure in which your surgeon will insert a metal-mesh cylinder-like tube, called a stent, which opens inside your carotid artery to increase blood flow in areas that have a blockage due to plaque.