Division and reanastomosis of the internal carotid artery for endarterectomy.

In an attempt to meet superior hemodynamic criteria without patch angioplasty and to prevent recurrent stenosis, Division-Endarterectomy-Reanastomosis (D.E.R.) was used as a routine technique in a prospective study on 26 consecutive interventions in 25 patients. One patient had a residual technical stenosis of less than 30%. Eight patients died during the one and a half year follow-up from nonstroke-related causes. After on an average 14 months flow parameters were evaluated with Color Duplex Sonography to detect recurrent stenosis. One (5.5%) mild asymptomatic recurrent stenosis of less than 50% was diagnosed. The residual stenosis remained unchanged and all other sites showed normal flow patterns. Division-Endarterectomy-Reanastomosis of the internal carotid artery, as described, meets all requirements for safe carotid restoration.