We have routinely carried out ultrasonographic examination during carotid endarterectomy (CEA) since 2006 for prevention of intraoperative complications. A small－sized probe (linear type,7–15MHz, about3cm in length) is used. Direct application of the probe to the carotid artery can yield more detailed information on plaque characteristics than that obtained through the skin before CEA. If plaque is vulnerable, the stenotic site must be manipulated so as to avoid direct pressure on the plaque for prevention of plaque rupture, which could induce cerebral embolism. Detection of the distal end of stenosis of the internal carotid artery and other plaques that are located in the common carotid artery is essential for safe clamping of these arteries and for insertion of an intraluminal shunt tube. After closure of the arteriotomy, ultrasonographic examination is able to confirm that the lumen is not immediately occluded or stenotic.
The present results indicate the effectiveness of interaoperative ultrasonographic examination for prevention of operative complications.
