Carotid endarterectomy requires a stay in hospital. Procedures may vary based on your condition and your healthcare provider's practices.

Generally, carotid endarterectomy (CEA) follows this process:

1. You will be asked to remove any jewelry or other objects that may interfere with the procedure.
2. You will remove your clothing and put on a hospital gown.
3. You will be asked to empty your bladder before the procedure.
4. An IV (intravenous) line will be started in your arm or hand. Another catheter will be put in your wrist to monitor your blood pressure and to take blood samples. One or more extra catheters may be put in into your neck, opposite the surgery site, to monitor your heart. Other sites for the catheter include the under the collarbone area and the groin.
5. If there is too much hair at the surgical site, the healthcare team may shave it off.
6. You will be placed on the operating table, lying on your back. Your head will be raised slightly and turned away from the side to be operated on.
7. A catheter will be put in into your bladder to drain urine.
8. The anesthesiologist will check your heart rate, blood pressure, breathing, and blood oxygen level during the surgery.
9. CEA may be done under local anesthesia. You will be sleepy, but will not feel the area being operated on. You will get a sedative in your IV before the procedure to help you relax. This lets the healthcare provider monitor how you are doing during the procedure by asking you questions and testing your hand grip strength.
10. If the CEA is done under local anesthesia, the healthcare provider will give you constant support and keep you comfortable during the procedure. You will get pain medicine as needed.
11. Under local anesthesia, you will get oxygen through a tube that fits in your nose.
12. A CEA may also be done under general anesthesia. This means you will be asleep. Once you are sedated, the provider will put a breathing tube into your throat and into your windpipe to provide air to your lungs. You will be connected to a ventilator. This machine will breathe for you during the surgery.
13. You will be given a dose of antibiotics through your IV to help prevent infection.
14. The healthcare team will clean the skin over the surgery site with an antiseptic solution.
15. The healthcare provider will make a cut (incision) down the side of the neck over the diseased artery. Once the artery is exposed, the provider will make a cut into the artery.
16. The healthcare provider may use a device called a shunt to divert blood flow around the surgery area. This will keep blood flowing to the brain. A shunt is a small tube that is put into the carotid artery to send blood flow around the area being operated on.
17. With the blood flow diverted, the healthcare provider will remove the plaque from the artery.
18. The provider will then remove the shunt and carefully close the artery. The incision in the neck will be stitched together.
19. A small tube (drain) may be placed in your neck. This will drain any blood into a small palm-size suction bulb. It is generally removed the morning after the procedure.
20. You may get blood pressure medicine through your IV during and after the procedure to keep your blood pressure within a certain range.
21. If you had general anesthesia, the healthcare provider will wake you up in the operating room to be sure you can respond to questions.
22. A sterile bandage or dressing will be put on the surgery site.