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(Stroke. 1998;29:2435-2441.)
© 1998 American Heart Association, Inc.

Special Report

Carotid Endarterectomy: A Saga of Clinical Science, Personalities, and Evolving Technology

The Willis Lecture

Presented as the Willis Lecture at the 23rd International Joint Conference on Stroke and Cerebral Circulation. Orlando, Fla, February 5, 1998

James T. Robertson, MD

From the Department of Neurosurgery, University of Tennessee, Memphis, Tenn.

Correspondence to James T. Robertson, MD, Department of Neurosurgery, University of Tennessee, Memphis, 847 Monroe Ave, Suite 427, Memphis, TN 38163. E-mail jrobertson@utmem1.utmem.edu

Key Words: carotid endarterectomy • stents • history • clinical trials • angioplasty

	Introduction

 
Mr Chairman, members, and guests of this annual international meeting on stroke, sponsored by the Stroke Council of the American Heart Association, an organization to which I have devoted over 20 years of admiration and service, it is an honor and privilege to present the Willis Lecture for 1998.

Sir Charles Willis published the Anatome of the Brain and Nerves over 300 years ago. Feindel edited an excellent compilation of Willis' work and published his tercentenary edition, entitled Cerebri Anatome, in 1964.¹ Willis' publication was more than anatomy of the brain and nerves. It set forth a number of functional as well as anatomic descriptions of the brain and the cranial nerves. The most significant point of the work was the description of the functional anatomy of the cerebral circulation. Willis applied, for the first time, the knowledge of William Harvey's brilliant discovery to the special problems of the blood supply to the brain. He gave the anatomic description of the arterial circle at the base of the brain. He recognized the significance of this unique vascular anastomosis. He supported his insight into the principle of collateral circulation to the brain by the intravascular injection of colored dyes and by ligation, in animals, of blood vessels supplying and draining the brain. Finally, he attempted to correlate the problems presented in his medical practice in light of these anatomic and experimental results often supported by autopsy observations. Clearly, he recognized that the carotid and vertebral arteries in the neck were . . . [Full Text of this Article]