Hazard of a postendarterectomy intimal flap in carotid artery surgery

A patient with severe bilateral carotid artery stenosis had an intimal flap after removal of the carotid plaque using the plaque cracker. Because use of the plaque cracker in the carotid artery surgery offers no significant advantages and allows the possibility of an intimal flap occurring in the carotid artery, this instrument should not be used in carotid artery surgery. The plaque cracker has been established as a useful instrument in peripheral vascular surgery in selected cases.