ABSTRACT
This is a left CEA in which it was necessary to open and repair the ECA as a separate incision. In this case the common to internal carotid arteriotomy remains open and the denuded area of vascular wall following plaque removal can be seen. A suture line is begun in the ECA and brought down in continuous, nonlocking fashion to the region of the carotid bulb where it is secured to a separately thrown single 6-0 Prolene stitch. The long tail of this stitch is then tied to one of the limbs of the main suture line when the common and internal carotid arteries are repaired. It is important to note that when I do open the ECA separately, I repair it first since there is a rather limited amount of time available for completion of the arterial suture line at the junction of the common and internal arteries, particularly in shunted cases.
