History of carotid surgery: from ancient greeks to the modern era

• Published in: Perspectives in vascular surgery and endovascular therapy Vol. 25; no. 3-4; p. 57
• Main Authors: Tallarita, Tiziano, Gerbino, Maurizio, Gurrieri, Carmelina, Lanzino, Giuseppe
• Format: Journal Article
• Language: English
• Published: United States 01.12.2013
• Subjects: Carotid Artery Diseases - history; Carotid Artery Diseases - therapy; Endarterectomy, Carotid - history; History, 19th Century; History, 20th Century; History, Ancient; Humans; Ligation; Randomized Controlled Trials as Topic - history; Suture Techniques - history; Vascular Surgical Procedures - history; carotid endarterectomy; transient ischemic attack; stroke; carotid surgical history
• ISSN: 1521-5768
• DOI: 10.1177/1531003513517010

A relationship between decreased carotid arterial flow and apoplectic manifestations was already suspected by the ancient Greeks. Early attempts at carotid surgery, however, were limited to emergency arterial ligation in patients with neck trauma. Attempts to suture arterial stumps together to restore blood flow paved the way for Carrel's revolutionary idea of reconstructing the resected or injured arterial segment with an interposition vein graft. DeBakey and Eastcott were the first to perform carotid endarterectomy in North America and the United Kingdom, respectively. In 1959, DeBakey proposed a cooperative study to assess the effectiveness of carotid endarterectomy in the treatment and prevention of ischemic cerebrovascular disease. The study was officially designated the Joint Study of Extracranial Arterial Occlusion and represented the first trial in the United States in which large numbers of patients were randomly allocated to surgical or nonsurgical therapy.