In carotid endarterectomy, you receive a local or general anesthetic. Your surgeon makes an incision along the front of your neck, opens your carotid artery and removes the plaques that are clogging your artery. Then, your surgeon repairs the artery with stitches or a patch made with a vein or artificial material (patch graft).
Sometimes surgeons may use another technique called eversion carotid endarterectomy. This involves cutting the carotid artery and turning it inside out, then removing the plaque. Your surgeon then reattaches the artery.
https://www.mayoclinic.org/tests-procedures/carotid-endarterectomy/about/pac-20393379