Perioperative Nursing Care for Patients Undergoing Carotid Endarterectomy: A Narrative Review

Abstract

Stroke is a major public health problem in Thailand, with more than 300,000 patients per year and a mortality rate of more than 50,000 per year. The disease poses a significant burden on the healthcare system, economy, and the quality of life of patients and their families. Carotid artery stenosis (CAS) is a critical risk factor for ischemic stroke, especially among elderly individuals with multiple comorbidities. Carotid endarterectomy (CEA) is considered the standard surgical intervention proven to be effective in preventing recurrent strokes, reducing the incidence of permanent disability, and improving survival rates. However, CEA is a complex procedure associated with potential complications such as perioperative stroke, myocardial infarction, and postoperative hematoma. These risks highlight the necessity for highly specialized nursing care, precise patient assessment, and close multidisciplinary collaboration throughout the perioperative period. This review aims to present comprehensive nursing approaches to the care of patients undergoing CEA, emphasizing assessment, monitoring, and evidence-based interventions across the preoperative, intraoperative, and postoperative phases. The discussion focuses on practical nursing strategies that enhance patient safety, optimize clinical outcomes, and minimize complications. Furthermore, the role of perioperative nurses in coordinating care, providing patient and family education, and supporting recovery is underscored. By integrating clinical expertise with collaborative practice, nurses play a pivotal role in improving patient prognosis and overall quality of care. This review is intended to serve as a practical reference for perioperative nurses and multidisciplinary teams in delivering safe, effective, and patient-centered care for individuals with carotid artery stenosis undergoing CEA.