
Thursday Jun 19, 2025
E35: Carotid Endarterectomy Mastery with Dr. Michael Roskos
How do you perform a carotid endarterectomy with confidence while ensuring patient safety in a rural setting?
Host Dr. Randy Lehman welcomes Dr. Michael Roskos, his former program director for the rural surgery track at Mayo Clinic, to dive deep into this critical procedure. They explore patient selection criteria, detailed surgical techniques, and the evolution of vascular surgery practice over the decades.
Dr. Roskos shares his experience practicing in La Crosse, Wisconsin, and his weekly surgeries in the small town of Arcadia, where he operated on patients whose families he'd known for generations.
Tune in for an in-depth discussion where technical mastery intersects with the unique demands of rural healthcare.
0:00 Introduction
1:52 Dr. Roskos’ Background and Path to Rural Surgery
4:11 Why Rural Surgery Is Special to You
6:08 How I Do It: Carotid Endarterectomy
29:30 Financial Corner
33:49 Classic Rural Surgery Story
39:30 Finding The Right Surgical Volume Balance
43:21 Resources for The Busy Rural Surgeon
45:03 Outro
Resources Mentioned
🌐 Rural surgery listserv: https://gaggle.email/join/distribution-list@rural-surgery.ca
🌐 National Comprehensive Cancer Network Guidelines (NCCN): https://www.nccn.org/guidelines/
🌐 UpToDate - Medical Resource recommended by Dr. Rosko: https://www.uptodate.com/
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