The carotid arteries are positioned, one on each side near the front of the neck, and are an important blood supply for the brain. If they become narrowed, small bits of blood clot can form around the narrowing, and then break off, up the artery to the brain. This blocks off the blood supply to the brain, either temporarily or permanently. Patients notice this as a ‘stroke’ We know from large research studies, that removing this narrowing in people who have had a small stroke, we can reduce the chance of them having a large stroke. Such operations are done through a cut in the neck, with the patient closely monitored, or more often awake. This allows the surgeon to make sure the brain is still working while operating on the blood supply to the brain. Unfortunately, such operations carry a small risk of producing a stroke, but this risk is far less than leaving the artery alone.

Stretching up the carotid artery (angioplasty) or stenting it has been tried to treat carotid artery disease, and prevent stroke, but it has not shown the promise it was hoped it might have. It is rarely performed in the UK.