Exoscope Guidance for Carotid Endarterectomy in Patients with Distally Extended Atherosclerosis: A Report of Two Cases

Abstract

Background: Carotid endarterectomy (CEA) may be challenging when atherosclerosis extends to the distal internal carotid artery. In these cases, CEA can be safely performed using an exoscope. Patients and methods: Two patients with atherosclerosis extending above the inferior margin of the C2 body underwent CEA with the aid of an exoscope (Hawksight; Mitaka Co., Ltd., Tokyo, Japan). Results and conclusion: With exoscope guidance, CEA for distal atherosclerosis was performed safely and conveniently in the natural operator position. The exoscope provided high magnification of the surgical field, allowing seamless carotid manipulation under both the naked eye and exoscope.