Subsequent to the arteriotomy made into the common carotid artery during a carotid endarterectomy, what is the very next step prior to closing the wound?

Prior to closing the wound after performing an arteriotomy in a carotid endarterectomy, checking for leaks is essential. This step is crucial because any leakage of blood from the surgical site can lead to serious complications, such as hematoma formation or even reoperation if not addressed immediately. Ensuring that there are no leaks confirms the integrity of the vessel and that the anastomosis is sound before proceeding with closure.

This step usually follows the removal of plaque and before the final suturing of the arteriotomy. The surgeon carefully inspects the site, sometimes using methods such as visual inspection and possibly Doppler ultrasound to ensure no bleeding is occurring. Only after confirming that there are no leaks, can the surgeon proceed to secure the arteriotomy.

The importance of this step cannot be overstated, as ensuring hemostasis is critical for a successful surgical outcome in carotid surgery.