Carotid endarterectomy is an open surgery to remove the plaque. A skin incision is made in the neck and the carotid artery is located. Temporary clamps are placed across the artery above and below the area of stenosis to stop blood flow. During this time, the carotid artery on the other side of the neck carries blood flow to the brain. The surgeon makes an incision in the artery over the blocked area. The plaque buildup is peeled out and removed. The artery is then closed with tiny sutures and the clamps removed to allow blood flow to the brain.