A large amount of research has been done to find the optimum timing for surgery. Despite what seems like a dangerous condition to have, research has shown that immediately fixing the carotid artery does not always benefit a patient. Some factors to consider:

1. We know that the risk of stroke increases with the amount of blockage – smaller blockages have low risk of stroke.
2. The benefit of surgery is to prevent a likely stroke.
3. The surgery itself can cause stroke and does not completely eliminate the risk of stroke after it is done.

Therefore, it makes sense to only operate on carotid blockage when the risk of a stroke is high. If it is not high, the risk of surgery is worse than the risk of having a stroke while watching the blockage over time. This timing may be affected by other factors (whether you’ve had a stroke or TIA already, whether your surgical risk is high). A vascular expert is trained to determine the optimal course of action for you.