CEA with a Special Focus on Surgical Position: An Approach to High Cervical Lesions Using a Basic Technique

Abstract

Carotid endarterectomy (CEA) is a well-established surgical technique; however, the use of an internal shunt and approach to high-level lesions vary depending on the surgeon and institution. Here, we describe the surgical position. Appropriate head rotation and mandibular elevation expand the retromandibular space and provide a surgical corridor to expose the distal end of the internal carotid artery. Because this procedure can be performed in the same surgical position and with the same techniques regardless of the plaque location, it could be easier to become proficient by using CEA. By acquiring experience and skills, CEA can be safely performed with an internal shunt even for high cervical lesions.