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