MEDICAL ANIMATION TRANSCRIPT: Your doctor may recommend you get a carotid endarterectomy if your carotid arteries are narrowed or blocked with plaque. In your neck are two major blood vessels called the carotid arteries, which carry oxygen-rich blood from your heart to your brain. You can feel of the pulse of the carotid artery in the side of your neck. Fatty deposits, called atherosclerotic plaques, can build up inside the carotid artery. These plaques can narrow the passageway of the artery and interfere with blood flow to the brain. This blockage or narrowing is called a stenosis. If blood flow to the brain is blocked temporarily, a transient ischemic attack, also known as a TIA, may occur. When the blood flow is completely obstructed, as in a carotid artery blockage, a stroke can occur. Before your procedure, an intravenous line will be started. A carotid endarterectomy is usually done under general anesthesia, which will put you to sleep for the duration of the procedure. In this case, a breathing tube will be inserted through your mouth and into your windpipe to help you breathe during the operation. Sometimes a carotid endarterectomy is done with local anesthesia. If local anesthesia is used, you will remain awake, but your neck will be numbed. You will probably also receive some sedation. On the side of your neck along the blocked artery, the surgeon will make an incision that may run fromjust behind the ear to a point above the collarbone. Your surgeon will find the carotid artery and temporarily clamp off blood flow through it. Your surgeon will open up the artery and may place a shunt or temporary bypass to keep blood flowing to the brain. Your surgeon will then remove the plaque within the arterial walls. After the blockage has been removed, he or she will sew the artery back together, usually placing a patch to widen thearteryslightly. The patch may be made of part of one of your veins, or an artificial material, such as Dacron. Finally, your surgeon will close the incision with sutures or staples and cover it with bandages. A temporary drain is frequently left in the wound. After your operation, you will be taken to a recovery area where the staff will monitor your vital signs and neurologic condition. You will be given pain medication as needed, and will gradually progress from a liquid to a solid diet.