Endarterectomy is a

surgical procedure Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery s ...

to remove the

atheroma An atheroma, or atheromatous plaque, is an abnormal accumulation of material in the tunica intima, inner layer of an arterial wall. The material consists of mostly macrophage, macrophage cells, or debris, containing lipids, calcium and a variabl ...

tous ''plaque'' material, or blockage, in the lining of an

artery An artery () is a blood vessel in humans and most other animals that takes oxygenated blood away from the heart in the systemic circulation to one or more parts of the body. Exceptions that carry deoxygenated blood are the pulmonary arteries in ...

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 The University of Lisbon (ULisboa; ) is a public university, public research university in Lisbon, and Portugal's largest university. It was founded in 1911, but the university's present structure dates to the 2013 merger of the former Universit ...

. In 1951, E. J. Wylie, an American, performed it on the

abdominal aorta In human anatomy, the abdominal aorta is the largest artery in the abdominal cavity. As part of the aorta, it is a direct continuation of the descending aorta (of the thorax). Structure The abdominal aorta begins at the level of the diaphragm ...

. The first successful reconstruction of the

carotid artery Carotid artery may refer to: * Common carotid artery, often "carotids" or "carotid", an artery on each side of the neck which divides into the external carotid artery and internal carotid artery * External carotid artery, an artery on each side of ...

was performed by Carrea, Molins, and Murphy in Argentina, later in the same year. Carotid Plaque

An endarterectomy of the carotid artery in the neck is recommended to reduce the risk of

stroke Stroke is a medical condition in which poor cerebral circulation, blood flow to a part of the brain causes cell death. There are two main types of stroke: brain ischemia, ischemic, due to lack of blood flow, and intracranial hemorrhage, hemor ...

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 in the 1950s prior to the advent of

coronary artery bypass surgery Coronary artery bypass surgery, also known as coronary artery bypass graft (CABG, pronounced "cabbage"), is a surgical procedure to treat coronary artery disease (CAD), the buildup of plaques in the arteries of the heart. It can relieve chest ...

to help patients with

angina Angina, also known as angina pectoris, is chest pain or pressure, usually caused by insufficient blood flow to the heart muscle (myocardium). It is most commonly a symptom of coronary artery disease. Angina is typically the result of parti ...

and

coronary artery disease Coronary artery disease (CAD), also called coronary heart disease (CHD), or ischemic heart disease (IHD), is a type of cardiovascular disease, heart disease involving Ischemia, the reduction of blood flow to the cardiac muscle due to a build-up ...

. It is still used today when coronary artery bypass surgery proves difficult. Livesay in

Texas Texas ( , ; or ) is the most populous U.S. state, state in the South Central United States, South Central region of the United States. It borders Louisiana to the east, Arkansas to the northeast, Oklahoma to the north, New Mexico to the we ...

and Nair in

Leeds Leeds is a city in West Yorkshire, England. It is the largest settlement in Yorkshire and the administrative centre of the City of Leeds Metropolitan Borough, which is the second most populous district in the United Kingdom. It is built aro ...

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 A surgical anastomosis is a surgical technique used to make a new connection between two body structures that carry fluid, such as blood vessels or bowel. For example, an Artery, arterial anastomosis is used in vascular bypass and a Colon (anatom ...

Pulmonary hypertension Pulmonary hypertension (PH or PHTN) is a condition of increased blood pressure in the pulmonary artery, arteries of the lungs. Symptoms include dypsnea, shortness of breath, Syncope (medicine), fainting, tiredness, chest pain, pedal edema, swell ...

caused by chronic thromboembolic disease (CTEPH) may be amenable to

pulmonary thromboendarterectomy In thoracic surgery, a pulmonary thromboendarterectomy (PTE), also referred to as pulmonary endarterectomy (PEA), is an operation that removes organized clotted blood (thrombus) from the pulmonary arteries, which supply blood to the lungs. Indi ...

of the

pulmonary artery A pulmonary artery is an artery in the pulmonary circulation that carries deoxygenated blood from the right side of the heart to the lungs. The largest pulmonary artery is the ''main pulmonary artery'' or ''pulmonary trunk'' from the heart, and ...

. This procedure was refined by Jamieson over the last two decades and his technique has become the standard worldwide.

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* * Vascular surgical procedures {{surgery-stub

See also

References

External links