ABSTRACT
When the plaque has been dissected circumferentially from the lumen of the carotid bulb and CCA, it is usually not possible to follow it far enough down the CCA to obtain a feathered edge, as is done in the ICA. I prefer to sharply transect the CCA plaque at the point where the caudad dissection ends. This can be accomplished with either a No. 15 blade or, as in this case, Church scissors. Once again, it is important to identify the back wall of the vessel so that it is not inadvertently buttonholed by either cutting technique. Once the plaque has been sharply removed from the CCA, it can be held up with the vascular forceps and removed from the internal and external carotid arteries.
