[Endarterectomy by division of the internal carotid artery]

The literature reports superior results with patch angioplasty compared to direct suture for the restoration of the carotid artery after endarterectomy through a longitudinal arteriotomy. With the technique presented here access to the arterial lumen is gained through an oblique division of the internal carotid at its origin. After endarterectomy this vessel is reanastomosed to its origin on the common carotid. This oblique suture does not induce any stenosis. This technique is easily reproducible. In a prospective randomized study, comparing its results to saphenous vein angioplasty, no significant difference was found on mortality, morbidity and recurrent stenosis. With this technique, the saphenous vein can be preserved for other vascular reconstructions.