Carotid and Femoral Endarterectomy

Some vascular diseases cause a waxy substance (plaque) to build up in your arteries. Large plaque deposits can limit blood flow or block the vessel, increasing stroke risk.

Expert care at Virginia Mason Franciscan Health includes endarterectomy, a surgical procedure to remove plaque buildups and restore blood flow. We offer a depth of endarterectomy experience, enabling more patients to achieve excellent outcomes.

This procedure may be necessary if vascular disease affects blood flow through a major artery. It’s for moderate to severe blockages. 

Options include: 

• Carotid endarterectomy to remove plaque buildups from the arteries that provide blood to the brain
• Femoral endarterectomy, which eliminates blockages in the blood vessel supplying the lower limbs

Vascular surgeons, many with advanced (fellowship) training, guide your treatment. Even if you have other medical conditions, like heart disease, we can help lower your risk of stroke with endarterectomy. Meet our team.

Highlights of our program include:

• Comprehensive services: We offer all the care you need for a seamless experience. The same team of providers is by your side from evaluation through treatment and recovery. You may start with advanced vascular testing in our accredited lab to measure blockages and help plan your procedure. 

• Appropriate care: We recommend endarterectomy only if it’s the right choice for your needs. Other options are available for minor plaque buildup or if your blood vessels aren’t healthy enough for an endarterectomy. Sometimes, vascular bypass surgery using a healthy blood vessel to route blood flow around the blockage is best.

• Timely treatment: We often catch blockages in earlier stages, making it possible to delay an endarterectomy or schedule it at a good time for you. For severe blockages or stroke-like symptoms, vascular surgeons perform the procedure on short notice.  

• Ongoing monitoring: Even if your endarterectomy is a success, keeping a watchful eye on your vascular health helps you avoid additional issues. We may recommend yearly checkups to manage your risk. These visits may involve ultrasounds to ensure areas of concern continue receiving good blood flow.

The procedure is for people with blood vessel blockages due to: 

• Carotid artery disease
• Peripheral artery disease (PAD)

It can help you get relief from symptoms and complications such as:

• Claudication, discomfort in your lower limbs that occurs with light physical activity
• Gangrene, tissue death due to poor blood flow
• Stroke-like symptoms, such as slurred speech, facial drooping and trouble walking

Endarterectomy is most commonly performed on the carotid arteries, followed by the femoral artery. The surgeon makes an incision of up to 10 centimeters (approximately four inches) to open the artery and access the blockage. We then use a special instrument to remove plaque. Surgeons use a patch of healthy blood vessel tissue to close the artery and stitches to seal the skin incision.

If other, less severe blockages are nearby, we may deliver additional therapies in the same procedure. These include angioplasty to widen narrowed vessels and hollow mesh devices (stents) to keep them open. 

Endarterectomy is a moderate risk vascular surgery that is well tolerated. You can expect to stay in the hospital for one or two days. We perform an ultrasound a few weeks after your procedure to ensure good blood flow through the artery. We will also see you in our offices a few days after discharge to ensure your recovery is on track.

Our specialists care for patients across the Puget Sound area and beyond.