Instead of pushing the plaque against the artery walls using angioplasty and stenting, a carotid endarterectomy removes the plaque from the narrowed artery. During this procedure, the surgeon creates an incision toward the front of your neck, opens the carotid artery, and removes the fatty plaque. Once the plaque is out, your surgeon will close the incision with either stitches or a graft. The graft used can either be from one of your own veins or it can be artificial material.