Direct surgery on arteries in the treatment of obliterative arterial disease has been used extensively since the pioneering work of Dos Santos, published in 1947.1,3,6,9,14 Thromboendarterectomy was followed by the use of arterial homografts2,10,13 and subsequently by the use of plastic prostheses, either as replacements or as bypasses for the involved segments. We have employed thromboendarterectomy almost exclusively over the past seven years. The present paper deals with a critical evaluation of this procedure based on experience in 87 cases treated on the private service of one of us (N. E. F.).
For the purpose of analysis, these cases have been divided into two main groups, depending upon whether the operation was performed for the relief of intermittent claudication or for the severer form of the disease, when the presenting complaint was rest pain, ulceration, or gangrene. As our experience has developed, we have been forced to become