The Procedual Protocol to Improve the Safety of Carotid Endarterectomy

Abstract

Carotid endarterectomy is still the standard treatment of carotid stenosis even after the introduction of CAS. However, due to the inherent difficulty of this operative technique, as well as the limited volume of surgical cases, it is quite difficult for young surgeons to master the CEA. To overcome this difficulty, we constructed a detailed and sophisticated procedual protocol of CEA. Under this protocol and the supervision of the senior author (K.T.), 7 senior residents performed 112 cases of CEAs between April 2004 and March 2007. The result of 112 cases were acceptable compared to those of large clinical studies to date. To pass the standard CEA technique across generations, a detailed and sophisticated surgical protocol is extremely effective, and the surgical result does not depend on who the surgeon is but on who the supervisor is and what the procedual protocol is.