Double-barreled tack suture procedure in carotid endarterectomy

The authors have developed a double-barreled tack suture procedure for carotid endarterectomy with minimal modification of a conventional needle holder. With this method surgeons can make two stitches simultaneously by using two needles threaded with double-armed suture material, which are held tightly in a parallel fashion in the jaws of a modified needle holder. This method is very effective in preventing the buckling of the intimal wall of the arterectomized distal internal carotid artery. Also, it reduces the tack suture time markedly compared with the conventional tack suture method.