In 1966, we1 first employed eversion endarterectomy for advanced obstructive disease of the aortoiliofemoral arteries. This technique consists of totally excising various portions of the aortoiliofemoral tree ranging from a single external iliac artery to the entire tree. After excision of the involved vessels, the outer or adventitial layer of the specimen is everted and pulled free of the central diseased core, which is then discarded. The residual media remaining on the everted adventitia is removed with a Freer dissector. The smooth, soft vessel is then inverted right side out and resutured into its normal position in the body. Flow may then be reestablished in the hypogastric vessels, as well as to the superficial and profunda femoris arteries.
The final result of this procedure is the same as conventional endarterectomy except that by excising the vessel and performing the endarterectomy by eversion, two advantages are evident: thorough endarterectomy can
Connolly JE, Stemmer EA. Eversion Endarterectomy of the Aortoiliofemoral ArteriesA Three-Year Experience. Arch Surg. 1970;100(4):461-469. doi:10.1001/archsurg.1970.01340220137023