Aim. Little data is available on surgical ‘‘rescue’’ of failed carotid stents (CAS). We have analyzed a series of CAS failures treated by conventional open surgery. Report. Five patients underwent surgery after CAS failure, either electively (4) or as an emergency (1). Elective surgical ‘‘rescue’’ was for stent restenosis (2 cases) or stent misplacement (2 cases). Emergency surgery was performed for entrapment of the protection system in the stent. Surgical rescue was accomplished by perimedial endarterectomy and ‘‘en bloc’’ plaque and stent extraction in 3 cases, and by vein bypass in 2 cases, with no neurological complications. Conclusion. Surgical rescue of failed CAS is effective.