dissection of the carotid arteries on the right side of the neck prior to carotid endarterectomy

the carotid arteries have now been clamped and an incision made from the common carotid into the origin of the internal carotid artery - the localised area of atheroma causing narrowing at the origin of the internal carotid artery is clearly seen

endarterectomy has now been completed with removal of the diseased inner layers of the artery wall - a smooth surface is left prior to closure of the incision in the artery and restoration of blood flow to the brain

the incision in the artery has now been closed using a patch of Dacron material to avoid narrowing the lumen of the artery.

in some cases, there is insufficient blood flow to the brain via the opposite carotid arteries to allow simple clamping of the diseased carotid artery during surgery - in this situation a temporary shunt can be inserted to maintain blood flow while the endarterectomy is carried out