Carotid endarterectomy

Our indications, contraindications, pertinent preoperative evaluation and treatment, operative technique, and postoperative care for carotid endarterectomy are presented in detail. When this procedure is performed in an orderly manner, the risks are low. We believe the following points are important in avoiding postoperative neurological complications: systemic heparinization, use of relative hypertension, routine use of an internal shunt, endarterectomy to the superior end of the arteriosclerotic plaque, firm attachment of intima at the ends of the endarterectomy, and avoidance of air embolism by back-flushing.