Carotid endarterectomy (CEA) for stroke prevention has been validated in many prospective randomized trials for treatment of carotid bifurcation disease. The technique of standard CEA has been performed with excellent results over the past three decades. An alternative approach involves eversion endarterectomy, which displaces the anastomosis from a narrow distal internal carotid artery to a larger carotid bulb and proximal internal carotid arteries. Exposure of the carotid artery is identical with either method of endarterectomy. Our results with this technique demonstrate a recurrence rate in women that is less than 2%, identical to that in men. Although it is always difficult to improve on a well-accepted technique, we believe that eversion endarterectomy is truly an advance in carotid surgery and one that we have adopted enthusiastically with excellent results. Whether this becomes the principal technique or merely an occasional technique of the operator, it is an important and useful tool for the surgeon who performs carotid procedures.
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