Endarterectomy of the internal carotid artery

Results of 219 operations in 171 patients for arteriosclerotic stenosis of the internal carotid artery were consistently good in patients with lateralizing, transient ischemic attacks. Although less consistent, relief of symptoms may be expected in a high proportion of patients with significant stenosis and more nonspecific symptoms. A small number of patients (10 percent) may have significant stenosis without a bruit. Asymptomatic stenosis, which has an unpredictable prognosis, may be operated upon with low mortality and morbidity. The use of local anesthesia and shunting when necessary proved to be the safest technique for the authors.