Intraoperative ultrasound during carotid artery surgery.

Intraoperative B-mode ultrasound (OPUS) has been used to scan 155 carotid bifurcations during endarterectomy. Intimal flaps, residual plaque and suture line stenosis were detected by this method. Most defects were found in the external carotid artery (11%) and the importance of adequately clearing this vessel is stressed. The internal carotid artery had defects in 8% of cases, most of which were of a minor nature (less than 30% encroachment on luminal diameter). The presence of minor technical defects at operation was not significantly associated with the development of postoperative bruits or restenosis. Major defects were corrected at the time of surgery. OPUS is a useful adjunct in ensuring a technically satisfactory endarterectomy.