The epic 1954 operation that led to one of surgery's major
advances: carotid endarterectomy
Corresponding address: John E Connolly, MD, Professor of
Surgery, University of California, Irvine, CA 92697, USA
E-mail: jeconnol@uci.edu
Abstract
The first report of a successful operation for carotid stenosis in 1954 owes credit to the neurologist Fischer who noted that carotid disease is localized and thus could conceivably be bypassed or locally excised. With this knowledge Professor Pickering of St Mary's Hospital, London, wisely obtained a carotid arteriogram on one of his patients and suggested to Rob and Eastcott that they surgically correct the block. Their famous successful operation in 1954 startled the medical world. However, only after clinical trials conclusively showed the benefit of carotid endarterectomy in preventing stroke, was it widely accepted. Modern advances in the technique of theprocedure are listed.
Eastcott, Pickering and Rob's original paper was published in the Lancet (Eastcott HHG, Pickering GW, Rob CG. Reconstruction of internal carotid artery in a patient with intermittent attacks of hemiplegia. Lancet 1954; 2: 994–6). The full article is reproduced online here, and we are grateful to Elsevier (www.thelancet.com) for permission to do this. The paper has been reproduced exactly as it originally appeared in print; the only alteration that has been made is to the layout.
Key words
Carotid; endarterectomy; clinical trials.
