Carotid artery surgery (Carotid Endarterectomy or Carotid Artery Stenting) prevents stroke by addressing plaque buildup (stenosis) in the carotid arteries located in the neck. This narrowing restricts blood flow to the brain and increases the risk of a neurological event. Recovery involves a phased approach, starting immediately after the procedure and extending into long-term medical follow-up.
Immediate Post-Surgical Phase
The initial phase of recovery focuses on acute stabilization and typically lasts for 24 to 48 hours within a hospital setting. Patients are moved to a recovery area for close monitoring following either open surgery (CEA) or a minimally invasive one (CAS). The medical team focuses on controlling the patient’s blood pressure, as fluctuations can increase the risk of complications like bleeding or stroke. Neurological function is checked frequently to ensure proper blood flow to the brain and detect immediate changes in speech or motor skills.
Pain management begins immediately with medication to control discomfort at the incision site, which is generally mild to moderate. For a Carotid Endarterectomy, a small drain may be placed in the neck to collect excess fluid, usually removed within the first day. Patients are encouraged to begin initial mobilization soon after the procedure, often sitting up and taking short walks the day after surgery to improve circulation. For Carotid Artery Stenting, the focus includes monitoring the groin or arm insertion site for bleeding, requiring the limb to be kept straight for several hours immediately afterward.
Short-Term Recovery Milestones
Once discharged, short-term recovery focuses on healing the surgical site and managing common physical symptoms over the next four to six weeks. Fatigue is a frequent experience during this time, which can last for several weeks. Neck soreness typically resolves within the first two weeks. Some patients may experience numbness along the jaw or near the earlobe that can persist for a few months due to minor nerve irritation near the incision.
Incision care at home involves keeping the site clean and dry, avoiding aggressive scrubbing, and not applying lotions or creams unless directed by a physician. Stitches or surgical tapes are generally removed or fall off within seven to ten days after the operation. Pre-existing conditions, such as diabetes or cardiovascular disease, and the patient’s age, can influence the speed of healing. Patients must be vigilant for warning signs like a fever, increased redness, a rapidly expanding bulge in the neck, or sudden changes in vision or speech, which signal a need for immediate medical attention.
Resuming Daily Life and Long-Term Follow-up
Functional recovery involves the gradual reintroduction of regular activities, a process that is typically complete within one to four weeks, depending on the individual and the nature of their work. Driving is usually permitted once the incision is healed and the patient can comfortably turn their head from side to side without pain or stiffness, often reached after the first two weeks. Restrictions on heavy lifting are common, with physicians advising against lifting anything over 10 pounds for approximately one month to prevent strain on the neck incision.
A return to work is highly variable; those with sedentary or desk jobs may be cleared to return within two weeks, while those with physically demanding roles may require four to six weeks of recovery. The formal medical clearance process involves a follow-up appointment with the surgeon, typically scheduled between four and eight weeks after the procedure. This appointment often includes a carotid duplex ultrasound, an imaging test to verify the artery remains clear and to establish a baseline for future monitoring. Long-term follow-up continues with regular duplex scans, often every six months for the first two years and then annually, to monitor for any sign of recurrent narrowing.