Twenty-five patients have undergone carotid endarterectomy by extraluminal dissection of the plaque. An incision is made into the media of the common and internal carotid arteries onto, but not through, the plaque to be excised. The plaque can then be dissected from the carotid bifurcation prior to entrance into the lumen of the carotid artery. The advantages of this procedure are less occlusion time, increased ease of dissection, and facilitation of complete removal of the plaque.