Endarterectomy is preferred by the authors rather than bypass grafting for occlusive disease of the aortoiliofemoral arteries in good risk patients. The eversion technique of endarterectomy permits complete direct vision disobliteration of inaccessible vessels such as the external iliac arteries.
A modification of the authors' original technique of eversion endarterectomy for occlusive disease of the aortoiliofemoral arteries is described and illustrated in the text. It consists of conventional endarterectomy of the terminal aorta and common iliac arteries, with transection of the common femoral arteries and their retraction into the abdominal cavity. Eversion endarterectomy of the external iliac and common femoral arteries is performed, after which the treated arteries are replaced beneath the inguinal ligaments and reanastomosed.