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Endarterectomy is a
surgical procedure Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...
to remove the
atheroma An atheroma, or atheromatous plaque, is an abnormal and reversible accumulation of material in the inner layer of an arterial wall. The material consists of mostly macrophage cells, or debris, containing lipids, calcium and a variable amount o ...
tous ''plaque'' material, or blockage, in the lining of an
artery An artery (plural arteries) () is a blood vessel in humans and most animals that takes blood away from the heart to one or more parts of the body (tissues, lungs, brain etc.). Most arteries carry oxygenated blood; the two exceptions are the p ...
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; pt, Universidade de Lisboa, ) is a public research university in Lisbon, and the largest university in Portugal. It was founded in 2013, from the merger of two previous public universities located in Lisbon, th ...
. In 1951, E. J. Wylie, an American, performed it on the abdominal aorta. 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 t ...
was performed by Carrea, Molins, and Murphy in Argentina, later in the same year. An endarterectomy of the carotid artery in the neck is recommended to reduce the risk of
stroke A stroke is a medical condition in which poor blood flow to the brain causes cell death. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding. Both cause parts of the brain to stop funct ...
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 pa ...
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 obstru ...
and coronary artery disease. It is still used today when coronary artery bypass surgery proves difficult. Livesay in
Texas Texas (, ; Spanish: ''Texas'', ''Tejas'') is a state in the South Central region of the United States. At 268,596 square miles (695,662 km2), and with more than 29.1 million residents in 2020, it is the second-largest U.S. state by b ...
and Nair in
Leeds Leeds () is a city and the administrative centre of the City of Leeds district in West Yorkshire, England. It is built around the River Aire and is in the eastern foothills of the Pennines. It is also the third-largest settlement (by populati ...
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 arterial anastomosis is used in vascular bypass and a colonic anastomosis ...
. Pulmonary hypertension 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.


See also

*
Atherectomy Atherectomy is a minimally invasive technique for removing atherosclerosis from blood vessels within the body. It is an alternative to angioplasty for the treatment of peripheral artery disease, but the studies that exist are not adequate to determ ...
*
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 ...


References


External links

* * Vascular surgical procedures {{surgery-stub