Endarterectomy

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Endarterectomy
Blausen 0172 CarotidEndarterectomy.png
Endarterectomy- plaque removal by surgical excision and closure
ICD-9-CM38.1
MeSHD004691

Endarterectomy is a surgical procedure to remove the atheromatous plaque material, or blockage, in the lining of an artery constricted by the buildup of deposits. It is carried out by separating the plaque from the arterial wall.

It was first performed on a subsartorial artery in 1946 by a Portuguese surgeon, João Cid dos Santos, at the University of Lisbon. In 1951, E. J. Wylie, an American, performed it on the abdominal aorta. The first successful reconstruction of the carotid artery was performed by Carrea, Molins, and Murphy in Argentina, later in the same year.[1]

Atherosclerotic plaque from a carotid endarterectomy specimen

An endarterectomy of the carotid artery in the neck is recommended to reduce the risk of stroke when the carotid artery is severely narrowed, particularly after a stroke to reduce the risk of additional strokes.

Coronary endarterectomy involves removing atheroma from the wall of blocked blood vessels (coronary) supplying the heart muscle. The concept was first introduced by Bailey[2] in the 1950s prior to the advent of coronary artery bypass surgery to help patients with angina and coronary artery disease. It is still used today when coronary artery bypass surgery proves difficult. Livesay[3] in Texas and Nair[4] in Leeds have published the largest series in the world.

A femoral endarterectomy is also frequently used as a supplement to a vein bypass graft at the sites of surgical anastomosis. Pulmonary hypertension caused by chronic thromboembolic disease (CTEPH) may be amenable to pulmonary thromboendarterectomy of the pulmonary artery. This procedure was refined by Jamieson over the last two decades and his technique has become the standard worldwide.[5]

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References[edit]

  1. ^ Thompson, Jesse E. (August 1996). "The Evolution of Surgery for the Treatment and Prevention of Stroke: The Willis Lecture". Stroke. 27 (8): 1427–1434. doi:10.1161/01.str.27.8.1427. PMID 8711815.
  2. ^ https://jamanetwork.com/journals/jama/article-abstract/320789
  3. ^ Livesay, James J.; Cooley, Denton A.; Hallman, Grady L.; Reul, George J.; Ott, David A.; Duncan, J. Michael; Frazier, O. Howard (October 1986). "Early and late results of coronary endarterectomy". The Journal of Thoracic and Cardiovascular Surgery. 92 (4): 649–660. doi:10.1016/S0022-5223(19)35867-2.
  4. ^ Ariyaratnam, Priyadharshanan; Javangula, Kalyana; Papaspyros, Sotiris; McCrum-Gardner, Evie; Nair, Ramanpillai Unnikrishanan (1 December 2012). "Long-term survival from 801 adjunctive coronary endarterectomies in diffuse coronary artery disease". European Journal of Cardio-Thoracic Surgery. 42 (6): e140–e145. doi:10.1093/ejcts/ezs510. PMID 23014969.
  5. ^ Jamieson, Stuart (2011-10-15). "Bypass, circulatory arrest, and pulmonary endarterectomy". The Lancet. 378 (9800): 1359–1360. doi:10.1016/S0140-6736(11)61384-6. ISSN 0140-6736. PMID 22000123.

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