A carotid endarterectomy (removal of the stenosis and the atheromatous plaque) was planned. This procedure is indicated in the presence of an ulcerating plaque with stenosis. The procedure was carried out under general anesthetic and a curvilinear incision was placed in the left side of the neck. The common carotid, external carotid, and internal carotid arteries were displayed. All vessels were clamped and a shunt was placed from the common carotid artery into the internal carotid artery to maintain cerebral blood flow during the procedure. The internal carotid artery was opened and the plaque excised.