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Carotid endarterectomy basics

(A) Surgical anatomy: common carotid artery (C), internal carotid artery (I), and external carotid artery (E). Also visible are the superior thyroid artery (S), ascending pharyngeal artery (P), and hypoglossal nerve (H). (B) Carotid bulb lumen after plaque removal. Note the Fogarty vascular clamp on the common carotid, the vessel loop around the external carotid, and a temporary aneurysm clip on the internal carotid. Umbilical tape is placed underneath the common carotid artery and internal carotid artery in anticipation of possible shunt placement. (C) Explanted carotid atherosclerotic plaque. (D) Patch graft made of bovine pericardium sutured into carotid arteriotomy site prior to closure. (Contributed by Dr. Joseph C Serrone and Dr. Daniel M Heiferman.)