Surgery

Surgery is considered useful in some cases of ischemic stroke (stroke caused by blood clots blocking blood flow).

The two carotid arteries in your neck supply blood to your brain. A carotid artery narrowed by fatty deposits from atherosclerosis may become blocked by a blood clot. When the carotid artery is more than 50 percent narrowed, then surgery may be necessary to reduce the risk of a full stroke. The most common surgery to prevent stroke due to blocked arteries is a carotid endarterectomy, which is a procedure that removes built-up plaque from a clogged carotid artery by removing the artery's inner lining. The surgery has been shown to prevent stroke in some people who have had mini strokes or people who are symptom free, but have significant blockage. Today, this surgery is proving more successful than ever in preventing stroke, reducing risk by as much as 55 percent.

Angioplasty is a surgical technique that may be used for people whose blockages are not opened with drugs. In angioplasty, a balloon-tipped catheter is inserted into an artery outside the brain. The catheter is threaded into the brain and into the partially blocked artery. The balloon inflates, pressing the plaque caused by cholesterol against the walls of the artery. This allows the blood to circulate.

Clipping is a surgical procedure used for the treatment of aneurysms, weak areas in the wall of a blood vessel. Clipping involves clamping off the aneurysm from the blood vessel which reduces the chance that it will burst and bleed.

A technique that is currently being investigated and has shown early promise is the placement of a carotid stent in a blocked carotid artery. A stent is a wire-mesh tube that is inserted into the clogged carotid artery to hold it open. It reaches the carotid artery through a catheter that is fed through a blood vessel in the body and up to the neck. This approach is less invasive than surgical endarterectomy.

Sources:
American Heart Association
Emory University School of Medicine
Heart Center Online
National Institute of Neurological Disorders and Stroke
National Heart Lung and Blood Institute