What artery is typically the last clamp to be removed during a Carotid Endarterectomy?

During a Carotid Endarterectomy, the internal carotid artery is typically the last vessel to be unclamped. The procedure involves the surgical removal of atherosclerotic plaques from the carotid arteries to reduce the risk of stroke.

Clamping is done to temporarily halt blood flow, allowing the surgeon to safely perform the endarterectomy. The sequence of unclamping is critical to ensure that blood can flow back through the vessels effectively while minimizing the risk of debris entering the blood circulation. The internal carotid artery is retained under clamp until the very end because it is the primary vessel that supplies blood to the brain. Ensuring it remains clamped until the end allows for the careful monitoring of the cerebral perfusion as the other vessels are gradually reestablished.

The common carotid artery provides blood to both the internal and external carotid arteries. However, unblocking the common carotid without ensuring the internal carotid has been appropriately prepared could lead to complications, such as emboli or inadequate cerebral perfusion. Therefore, maintaining clamping on the internal carotid artery until the procedure is complete is vital for patient safety and optimal outcomes.