Comparison of two surgical techniques for carotid endarterectomy: Conventional and eversion

• Published in: Neuro-chirurgie 2014-02, Vol.60 (1), p.33-37
• Main Authors: Yasa, H, Akyuz, M, Yakut, N, Aslan, O, Akyuz, D, Ozcem, B, Tulukoğlu, E, Gurbuz, A
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Carotid artery; Carotid Stenosis - diagnosis; Carotid Stenosis - surgery; Conventional; Endarterectomy; Endarterectomy, Carotid - methods; Endartériectomie; Endartériectomie conventionnelle; Endartériectomie par éversion Carotide; Eversion; Female; Follow-Up Studies; Humans; Male; Medical sciences; Middle Aged; Neurosurgery; Neurosurgical Procedures - methods; Recurrence; Retrospective Studies; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Treatment Outcome
• ISSN: 0028-3770; 1773-0619
• DOI: 10.1016/j.neuchi.2013.12.003

Abstract Background The role of carotid endarterectomy for the treatment of atherosclerotic carotid bifurcation disease is now well established. The aim of this study was to compare durability, postoperative death, stroke, minor strokes, cranial nerve injuries, neck hematomas, myocardial infarctions, or surgical defects and restenosis at the operative site following short- and mid-term duration of the advantages eversion carotid endarterectomy (E-CEA) compared to conventional carotid endarterectomy (C-CEA). Patients and methods Between March 2003 and November 2012, primary CEAs were performed in 380 consecutive patients by the same surgical groups. These patients were evaluated retrospectively. C-CEA was performed in 202 patients, and E-CEA was performed in 178 patients. Carotid duplex ultrasonography was performed in all patients at 1, 6, 12 and 24 months after CEA to identify residual atherosclerotic carotid disease. Results Mean age was 67.3 ± 13.4 years in the E-CEA group and 64.8 ± 14.8 years in the C-CEA group. Mean cross-clamping time in the E-CEA group was 9.54 ± 2.6 minutes and 12.62 ± 2.7 minutes for C-CEA group ( P = 0.236). Three postoperative strokes occurred (one after E-CEA and two after C-CEA). In the E-CEA group and C-CEA group respectively, carotid stenosis rates were found in 4 patients (2.24%) and in 5 (2.97%) at a follow-up period of 26 months. Conclusion Classical endarterectomy still remains the gold standard surgical technique for patients who are selected for coronary artery disease surgery. Nevertheless, we believe that eversion endarterectomy, which has some advantages, must be kept in mind as an alternative approach.