Figure 2.

Carotid endarterectomy offers a prime opportunity to deliver pharmacological therapies to increase angiogenesis, retard cell death, and decrease inflammation as well as understand neuroadaptation to stress. Pictured is the surgical removal of plaque from the carotid artery performed to increase blood flow to the brain and prevent strokes. Image shows the exposed common carotid artery and its branches. A cleavage plane is achieved between the plaque and the healthier remaining parts of the artery. The plaque, a pale yellow sheath which is in the grip of the forceps is removed. Plastic tubing bridges between the internal and common carotid artery to provide a detour for blood and provide blood flow to the brain while the operation is preformed. As evidenced in this figure, the CNS access granted by a relatively minimally invasive procedure has proved to be the most useful means of surgical stroke prevention and offers an outstanding opportunity to assess neurochemical, physiological, and molecular changes that accompany impaired blood flow to the human brain. Image courtesy of the Vascular Disease Centre, Vascular Surgery, University of Hong Kong.