Carotid endarterectomy with reconstruction techniques tailored to operative findings

Completion ICA endarterectomy endpoint with arteriotomy that does not extend distal to ICA bulb and reconstruction with primary closure.

Completion ICA endarterectomy endpoint requiring arteriotomy extending distal to ICA bulb and patch reconstruction.

Method of management of long tongue of thick plaque in ICA with use of inversion tacking sutures over cut tongue (left view) with patch reconstruction (middle views), or saphenous vein interposition graft reconstruction with suturing of vein graft over tongue of plaque (right view).

Method of eversion plication shortening of endarterectomized ICA segment to prevent kinking after patch reconstruction.