The recent surgical literature1 indicates an increasing acceptance of the direct surgical treatment of obstructive arteriosclerosis. As summarized by Longmire1g in 1954, the removal of the obstruction and reestablishment of the vascular channel by (1) resection and replacement by a suitable vascular graft or by (2) thromboendarterectomy have both been successful. Which of the two methods is superior awaits further clinical experience. There may be an increasing tendency to reserve homograft replacement for the treatment of aortic aneurysms and possibly femoral arteriosclerotic occlusions and to use thromboendarterectomy for segmental occlusive disease of the lower aorta or the iliac arteries.2 In arteriosclerosis, the accumulation of cholesterol, fatty acid salts, and tissue debris creates a line of separation between the relatively uninvolved outer coat and the diseased intima of the artery. Gradual narrowing of the arterial lumen by the accumulation often leads to complete occlusion. Thromboendarterectomy is possible because
Kruse CA, Kirby FG. MAXIMUM BENEFIT FROM THROMBOENDARTERECTOMYTREATMENT OF COMMON ILIAC ARTERY OCCLUSION, WITH THREE-YEAR FOLLOW-UP. JAMA. 1956;161(4):324–326. doi:10.1001/jama.1956.62970040001007
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