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Carotid Endarterectomy is performed by removal of blockages in the arteries of the neck and the head. This surgery treats partial or complete blockage of the arteries of the neck and head that carry blood to the brain. Before carotid endarterectomy can begin, the individual is given a general anesthetic and the neck is shaved and scrubbed with soap and antiseptic and is draped so that the part of the incision is open. After, the skin is opened to expose the arteries. There are 3 common procedures for blockages of carotid arteries. The external and internal carotid arteries run more or less vertically up and down the neck behind the main carotid artery, which runs from the front of the neck to the back of the head at around 15 degree angle. In head and neck endarterectomy, the artery that needs to be worked on is open and the blockage is exposed. Depending on the circumstances, the doctor can construct a temporary or permanent bypass around the obstruction, using a piece of vein from elsewhere in the body or a Darcon vascular graft. If the bypass is temporary, the doctor clears the blockage by any methods such as literally blowing the obstruction out of the artery, using a stream of carbon dioxide. If the bypass is permanent, the blocked part of the artery can be left in place or cut away. In some cases, the incision in the artery may not be closed because it is too large or the edges are damaged. In this situation, a patch is made from a vein that is taken from elsewhere in the body, and sewn over the hole. The neck is closed and bandaged. The individual is then transferred to the recovery room. Carotid endarterectomy is usually performed by neurosurgeons, cardiovascular surgeons or general surgeons at a hospital facility.
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