Although endovascular surgery is slowly replacing open vascular surgery, femoral-popliteal bypass surgery (aka femero-politeal surgery or fem-pop surgery) continues to be frequently performed for the treatment of peripheral vascular disease.

Athough endovascular techniques have supplanted many of the indications for open repair of abdominal aortic aneurysms, the open procedure is still performed when endovascular repair is not deemed feasible.

Placement of a central venous catheter or central venous line is a commonly performed procedure in medicine. These catheters are commonly placed in the subclavian vein, jugular vein, and femoral vein.

Indications

Large volume resuscitation in hemorrhage, sepsis, or systemic inflammatory response syndrome.

Administration of hyperalimentation (total parenteral nutrition)

Administration of cardiac inotropes or pressors

Placement of a pulmonary artery catheter

Indications

Contraindications

Complete occlusion – somewhat counterintuitively, once the carotid artery has been completely blocked by atherosclerotic plaque it is not possible to remove the plaque surgically without an almost certain cerebrovascular stroke occurring postoperatively.

Incision

Details of the Procedure

1. Dissection is done through the platysma muscle.

2. Care must be taken to not extend the upper end of the incision too far anteriorly to avoid damaging the marginal mandibular branch of the facial nerve that runs just inferiorly to the horizontal ramus of the mandible (injury here causes lower lip paralysis).

Continue reading "Carotid Endarterectomy (Plaque Removal Surgery)"