Carotid endarterectomy.

Thousands of carotid endarterectomies are now performed each year. In properly selected patients in the hands of competent surgeons, the mortality and morbidity rate should not exceed 2 per cent. Although the long-term results are good, this procedure is prophylactic, and a patient who has already sustained a fixed neurologic deficit will rarely be improved by increasing the blood flow in the carotid arteries. This procedure, probably more than any other in the armamentarium of the vascular surgeon, depends on meticulous attention to detail and careful and gentle handling of tissue.