THE INTRODUCTION of endarterectomy has provided the surgeon with a tool for direct attack upon arteriosclerotic obstruction of the major arteries. Endarterectomy has been greeted with interest, but some of the original enthusiasm has been tempered by the disappointment associated with unexpected failures.
Experience with this operation at Veterans Administration Hospital has varied from unsatisfactory to extremely good. Because most of the initial failures appeared to have been caused by technical problems or faulty selection of patients it was believed that a review of a series of cases of thrombotic obstruction of major arteries might be of value to others in evaluating endarterectomy and its indications.
Rather than stressing the favorable results, this paper will emphasize the reasons for unsuccessful outcome and will suggest some techniques that may diminish the hazard of failure.
Forty-three patients who had chronic obstruction of a major artery have been seen in consultation by