![]() Eversion endarterectomy is an alternative surgical technique that allows plaque removal without longitudinal arteriotomy and potentially avoids placement of a patch however, this technique is less frequently practiced. Closure of the arteriotomy with a patch minimizes the effect of neointimal hyperplasia and scarring, maintaining arterial lumen diameter after the procedure. Unfortunately, closure of the longitudinal arteriotomy also allows for the possibility of narrowing the artery, either immediately or in delayed fashion, thus mimicking the stenosis for which the surgery was originally performed. ![]() 2 – 4 The standard surgical approach for CEA involves a longitudinal arteriotomy from the common to the internal carotid artery, allowing plaque removal. Approximately 100,000 CEA are performed annually in the United States. Since surgical repair of symptomatic carotid artery stenosis was first reported by Eastcott and colleagues in 1954, 1 carotid artery endarterectomy ( CEA) has remained the standard management strategy for significant carotid stenosis in both symptomatic and asymptomatic patients.
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