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Home > Vascular Annual Meeting^® > VS6. Carotid Endarterectomy by the Eversion Technique...

VS6. Carotid Endarterectomy by the Eversion Technique

Fred W. Rushton, Justin D. Manley, Huey B. McDaniel, Zachary K. Baldwin, Marc E. Mitchell
University of Mississippi Medical Center, Jackson, MS

OBJECTIVES: Carotid endarterectomy has evolved from a technique of excision of the stenotic segment and re-anastomosis to the more commonly employed method of removal of the atheromatous plaque through a longitudinal arteriotomy. Onlay patch closure has more recently been considered to be preferable to simple closure because of concerns for narrowing the vessel. In our practice, we have adopted a technique that avoids the expense of and complications associated with a prosthetic patch, yet avoids narrowing the internal carotid lumen at its smallest diameter. The procedure is most commonly done in our institution in awake patients under local/cervical block anesthesia and offers excellent circumferential visualization of the “end-point” transition of the excised plaque to normal intima. We will demonstrate the technical aspects of the procedure.

METHODS: A video presentation demonstrates the technique of eversion endarterectomy of the internal carotid artery.

RESULTS: The video presents the primary aspects of the eversion technique, including preoperative planning, technical considerations, and potential complications. We have been utilizing this technique for the past seven years with few complications and no postoperative strokes.

CONCLUSIONS: Eversion endarterectomy of the carotid artery is a safe and cost-effective procedure with excellent outcomes.

AUTHOR DISCLOSURES: W. Rushton, ev3; J.D. Manley, ev3, H.B. McDaniel, ev3; Z.K. Baldwin, ev3; M.E. Mitchell, ev3.