Yes, it is risky. Even the temporary balloon occlusion, and cervical angiography testing, to see if you're a candidate for surgery is a risk. I had read 30% risk of stroke, 25% of death with the carotid removal. When my doctor told me pre-op of the customary risks, he said 5%. I was like that's good, better than I thought. Even still there are risks after. A nurse told me the doctor said he's a tough dude, and called me miracle man lol. That's why not many doctors do this or can do this surgery.

It's difficult to say if it is involved just by radiologic scanning with a CT or MRI. Most thought to be are not, and may be inflammation, fibrosis, mimicking involvement, which about 37-42% are. I had carotid involvement in 2011, and the cancer was scraped off, and alloderm placed on the carotid to protect it. That was removed in a subsequent dissection, and pec flap placed.

You're in good hands at MDAnderson. Good luck