Carotid Endarterectomy

 
  • Incision is along the anterior border of the SCM.
  • Retract the SCM laterally.
  • Ligate the facial vein.
  • Isolate the CCA at the level of the omohyoid.
  • Continue dissection distally.
  • Can retract hypoglossal nerve anteriorly off the ICA.
    • can divide digastrics.
    • can dislocate mandible
  • Dissect out ECA to its first branch (superior thyroid artery).
  • Heperanize (100 Units / kg).
  • Clamp:
    • ICA
    • ECA
    • CCA
  • Open the artery and feather out the plaque.
  • Close with patch and flush ICA.
  • Unclamp:
    • ECA
    • CCA
    • ICA
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