This operation is designed to avoid stroke. However, 1 in 100 to 2 in 100 patients who have this operation can have a stroke during the procedure or immediately afterward. The use of shunts during the operation and careful technique have minimized this risk. If a stroke does occur, it could be very mild and resolve quickly or can cause a permanent impairment with movement or speech.

The neck is a congested zone of important structures. The location of each structure is well-known by your vascular surgeon. Anomalies occasionally exist in the individual neck. The anomalies, while usually not causing any problem with the procedure, may cause inadvertent damage to a local neurologic structure which can cause diminished function.

Hypoglossal Nerve – The nerve that carries signals to the tongue is called the hypoglossal nerve. It is located near the area of the carotid artery, which need to be cleaned of plaque. Occasionally, after surgery, patients notice that their tongue seems "funny" or "thick." Generally, this is very short-lived and returns to normal by two weeks. Occasionally, a permanent weakness of the tongue occurs.

Vagus Nerve – The nerve that carries signals to the vocal folds is part of the vagus nerve. It is located near the area of the carotid artery that needs to be cleaned of plaque. Occasionally, after surgery, patients notice that their voice is hoarse or weak. Generally, this is very short-lived and returns to normal by two weeks. Occasionally, a permanent change in voice occurs.

Cervical Nerves – These are nerves that control the movement of the muscles about the mouth. These are rarely injured but weakness of the corner of the mouth has been reported and can be permanent.