Heart and vascular surgery · Saint Petersburg
Carotid Endarterectomy
Reliable stroke prevention for carotid artery narrowing
Free under CHI and federal quotas
when indicated and with a referral
Text reviewed by Andrey Sorokin, endovascular surgeon
What carotid endarterectomy is
Carotid endarterectomy (CEA) is carotid artery surgery in which the surgeon removes an atherosclerotic plaque to prevent it from rupturing and causing thrombosis. It is performed for severe carotid stenosis, usually over 70%, to reduce the risk of ischemic stroke. At Pirogov Clinic in Saint Petersburg the operation takes 1–1.5 hours, with discharge the next day.
The narrowing is caused by atherosclerosis: a cholesterol plaque reduces the lumen of the common or internal carotid artery. This can lead to the formation of microthrombi and trigger an ischemic stroke.
Removing the plaque from the carotid artery restores the normal lumen of the artery and significantly reduces the risk of acute cerebrovascular events. Read more about the condition: Internal carotid artery stenosis.
Carotid endarterectomy in numbers
- operation time
- 1–1.5 hours
- neck incision
- 4–6 cm
- discharge
- Next day
- anesthesia
- Local or general
When carotid artery surgery is needed
The operation is indicated for severe stenosis (narrowing) of the carotid artery by more than 70% when the plaque shows signs of a high risk of thrombosis.
The vascular surgeon determines the indications based on symptoms, duplex ultrasound and CT of the neck vessels. Sometimes stenosis causes no symptoms and is found by chance during an examination. A narrowing of 50% is already a reason for concern, and from 70% the surgeon is more likely to recommend surgery.
Tests before carotid endarterectomy
Before the procedure, a comprehensive evaluation is performed:
- Duplex ultrasound of the neck vessels (brachiocephalic arteries)
- CT angiography of the brachiocephalic arteries
- Consultations with a vascular surgeon and an anesthesiologist
The patient’s overall condition is also assessed, and the type of anesthesia — local (regional) or general — is chosen together with the anesthesiologist. Under local anesthesia the patient stays conscious, and the team keeps verbal and visual contact. Under general anesthesia the patient sleeps and wakes up after the operation.
How carotid endarterectomy is performed
Neck incision
A 4–6 cm incision is made on the front side of the neck.
Exposing the artery
The surgeon carefully isolates the section of the artery affected by atherosclerosis and separates it from the surrounding nerves and veins.
Removing the plaque
The plaque is removed under microscopic optics. In the eversion technique the artery is cut off, turned inside out, the plaque is removed and the artery is sewn back.
Closing the artery
The artery is sutured directly or with a special patch. The surgeon makes the final choice of technique during the operation.
Restoring blood flow
Blood flow is restored and the sutures are checked for tightness.
Cosmetic suture
The wound is closed with a neat cosmetic suture.
The average duration of the operation is 1–1.5 hours. In most cases intensive care monitoring is not required.
Recovery and outlook after surgery
- Discharge is often possible the next day
- Thanks to the short hospital stay, the risk of infectious complications is minimal
- After surgery it is important to strictly follow medical advice: take prescribed medications regularly, monitor blood pressure and cholesterol, and keep to a diet
Carotid endarterectomy significantly reduces the risk of stroke and improves blood supply to the brain. When following medical advice, the patient can return to their normal lifestyle within a few days.
Atherosclerosis is a chronic disease, so after surgery it is important to control risk factors and have follow-up neck ultrasound as recommended by your physician.
Doctors who perform carotid endarterectomy
Dmitriy Shmatov
Professor, Deputy Director for Medical Affairs (Cardiac Surgery), Head of the Department of Cardiovascular Surgery, St. Petersburg State University Medical Institute
Maksim Kamenskih
Head of the Cardiac Surgery Department with an office for X-ray endovascular diagnostics and treatment
Vasily Balakhonov
Cardiovascular Surgeon
Victor Pyagai
Cardiovascular Surgeon
Free under CHI and federal quotas
At Pirogov Clinic carotid endarterectomy is performed free of charge under the CHI policy and federal quotas for high-tech medical care, when indicated and with a referral. Our administrators will help you arrange the quota and prepare the documents.
Questions about carotid endarterectomy
It is an operation in which the surgeon removes an atherosclerotic plaque from the carotid artery. It restores normal blood flow to the brain and significantly reduces the risk of ischemic stroke.
Surgery is indicated for severe narrowing of the carotid artery, usually by more than 70%, especially with symptoms of impaired blood supply to the brain. The vascular surgeon determines the exact indications after an examination.
Carotid stenosis has no specific symptoms; only its link with a previous stroke has been proven.
A 4–6 cm incision is made on the neck, the affected section of the artery is exposed and the plaque is removed under microscopic optics. The artery is then sutured, directly or with a patch, blood flow is checked and a cosmetic suture is applied. The operation takes 1–1.5 hours.
Local (regional) or general anesthesia is used. The type of anesthesia is chosen individually after consulting an anesthesiologist.
It is a technique in which the artery is cut off, turned inside out, the plaque is removed and the artery is sewn back. The surgeon chooses the technique depending on the anatomy and the nature of the lesion.
Both methods relieve the narrowing but suit different patients. The choice depends on anatomy, the nature of the plaque, age and other diseases. The vascular surgeon decides after an examination.
Duplex ultrasound of the neck vessels, CT angiography of the brachiocephalic arteries, consultations with a vascular surgeon and an anesthesiologist, and an assessment of the patient’s overall condition.
In most cases the patient is discharged the next day if their condition is stable. Intensive care monitoring is usually not required.
With proper indications and preparation the risks are minimal. The operation is performed by experienced surgeons using modern equipment and microscopic optics.
Most patients return to their normal lives within a few days. It is important to take prescribed medications regularly, monitor blood pressure and cholesterol, follow a diet and see your physician.
Atherosclerosis is a chronic disease, so after surgery it is important to control risk factors and have follow-up neck ultrasound as recommended by your physician.
At Pirogov Clinic the operation can be performed free of charge under CHI or a federal quota. Paid treatment starts from 127,400 rubles.
Conditions it treats
- AtherosclerosisNarrowing of arteries due to cholesterol plaques, leading to impaired blood flow and risk of heart attack, stroke, or gangrene.Learn more
- Internal Carotid Artery StenosisNarrowing of blood vessels due to atherosclerotic plaques, increasing the risk of ischemic stroke, especially when narrowing exceeds 70%.Learn more
Related procedures and diagnostics
- Computed TomographyCT of the heart and vessels, CT angiography of the aorta and coronary arteries: detailed cross-sectional images for precise diagnosis and surgical planning.Learn more
- Coronary artery stentingMinimally invasive surgery that restores blood flow in the arteries of the heart, preventing heart attacks and other complications.Learn more
Patient reviews
Patients tell about their treatment at our center — reviews that mention “Carotid endarterectomy”: 15 reviews. The latest are below.
I want to express huge gratitude to the vascular surgeon Andrey Alexandrovich Sorokin. I, Oksana Vasilyevna Novikova, underwent an operation with him — a right-sided eversion carotid endarterectomy, on September 28, 2026 (ICD-10: I65.2 Occlusion and stenosis of carotid artery), and I want to share my impressions. Andrey Alexandrovich is a God-given doctor. From the first appointment he won me over with his attentive attitude and detailed explanations. He did not just examine me and prescribe treatment, but told me in detail about my problem, explained all the risks and offered the optimal plan for the operation. His calmness and confidence gave me hope. The operation itself went successfully. Andrey Alexandrovich is a true professional in his field, a surgeon with golden hands. After the operation he did not leave me without attention, asked about my well-being, and gave clear recommendations for recovery. Thanks to his skill, I quickly got better and now feel much better. I especially want to note the doctor's human qualities: he is always polite, tactful and patient. He answers all my questions, even the seemingly most insignificant ones, in detail and clearly. You can feel that it is important to him not just to perform the operation, but for the patient to fully recover and feel comfortable. Huge thanks to Andrey Alexandrovich for his work, professionalism and sensitive attitude towards patients! A low bow! Respectfully, Oksana Vasilyevna Novikova.
Novikova O.V.
Review of the doctorAndrey SorokinEndovascular SurgeonI had an appointment with Andrey Alexandrovich Sorokin at the medical center on Stachek Avenue. I chose the doctor and the clinic based on online reviews. I came regarding carotid artery stenosis and ultrasound results. The doctor listened to me very attentively, explained the problem and risks in detail, and proposed surgery after first ordering an additional examination. On June 22, 2026, I was admitted to the inpatient department of the clinic at Fontanka 154. The next day, I underwent surgery — eversion carotid endarterectomy. The operation was successful. The next day, I was already getting up and walking through the corridors, and the day after that I was discharged. I would like to note Andrey Alexandrovich’s high professionalism. I feel very well; the incision does not hurt, and even my shortness of breath seems to have decreased. I noticed that I started walking faster. My stay at the clinic was very comfortable: clean, spacious wards, comfortable beds, excellent bed linen, and very tasty food, including fruit, dairy products, and fresh vegetable salads. The clinic staff were very friendly and responsive. I have been in different hospitals in St. Petersburg, and the Pirogov Clinic is the best. I recommend everyone with vascular problems to contact Dr. A.A. Sorokin.
Anonymous
Review of the doctorAndrey SorokinEndovascular SurgeonI first came to the clinic to see a cardiologist because of heart pain and shortness of breath. I underwent stress echocardiography and coronary angiography, and based on the results, CABG surgery was indicated. The surgery was performed on March 19, 2026, and I recovered quickly afterward. The operation was performed with high quality. During the preoperative examination, it was also discovered that I had a problem with my carotid artery. When I was discharged, I was immediately given a referral for the next operation. I was hospitalized again on June 19, and on June 22 I underwent carotid artery surgery. The operation was successful, and by the evening I was already in the ward. Now I feel wonderful. I would like to say a big thank you to Alexey Alexandrovich Filippov. He participated in both of my operations, changed my dressings, and helped me recover. I will recommend this specialist to everyone. Excellent clinic, very polite and kind staff.
Anonymous
Review of the doctorAlexey FilippovCardiac SurgeonI had my first surgery in February — bypass surgery. The second surgery was in May, when my left carotid artery was cleaned. Both operations were successful. Thank you to the doctor. Good attitude toward patients.
Anonymous
Review of the doctorAndrey SorokinEndovascular SurgeonI had my first surgery in February — bypass surgery. The second surgery was in May, when my left carotid artery was cleaned. Both operations were successful. Thank you to the doctor. I liked everything. Good attitude toward patients.
Anonymous
Review of the doctorAndrey SorokinEndovascular SurgeonHow to get care at the Center
- Free under CHI and quotasStep-by-step guide: which documents you need and how to get treatment free of charge.Learn more
- Choose your surgeonSupport program: your operation is performed by the cardiac surgeon you choose.Learn more
- Online expert opinionAn online talk with a cardiologist about your documents — for patients from other cities.Learn more
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