This is believed to be the first successful case of thromboendarterectomy for cerebrovascular insufficiency caused by atherosclerotic occlusion of the carotid artery, as well as the longest follow-up study. At the time of the patient's death from coronary occlusion, 19 years after operation, he had no cerebrovascular symptoms, and there was clinical evidence of maintenance of the restored circulation in the carotid artery.