Durability of eversion carotid endarterectomy: Comparison with primary closure and carotid patch angioplasty

Objectives: Despite numerous studies in which various methods for arteriotomy closure after carotid endarterectomy (CEA) have been addressed, the optimum surgical technique to reduce complications and late carotid restenosis has yet to be firmly established. The purpose of this study was to prospect...

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Bibliographic Details
Published in:Journal of vascular surgery 2001-09, Vol.34 (3), p.453-458
Main Authors: Katras, Tony, Baltazar, Ulises, Rush, Daniel S., Sutterfield, W.Chris, Harvill, Leo M., Stanton, Paul E.
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Carotid Stenosis - surgery
Endarterectomy - methods
Endarterectomy, Carotid - methods
Female
Humans
Male
Medical sciences
Neurosurgery
Prospective Studies
Skull, brain, vascular surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Time Factors
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Summary:Objectives: Despite numerous studies in which various methods for arteriotomy closure after carotid endarterectomy (CEA) have been addressed, the optimum surgical technique to reduce complications and late carotid restenosis has yet to be firmly established. The purpose of this study was to prospectively compare the results of the eversion CEA technique with those of conventional CEA with either primary closure or carotid patch angioplasty, and to determine under clinical conditions whether eversion CEA influences the results and restenosis rate. Patients and Methods: Over a 3-year period, 322 CEAs performed on 296 consecutive patients were concurrently evaluated. This study included 118 eversion CEAs, 97 CEAs with primary closure, and 107 CEAs with patch angioplasty. There were no differences in demographics, in surgical indications, or in the severity of carotid disease (not significant [NS]). The choice of CEA technique was not randomized because of technical considerations and surgeon preference. After entry into the protocol, no patients were excluded or withdrawn. Carotid restenosis was defined as a > 60% lumen reduction at the CEA site with established duplex ultrasonography criteria. Results: The mean operative time for eversion CEA was 31 minutes, for CEA-primary closure it was 39 minutes, and for CEA-patch angioplasty it was 46 minutes (P
ISSN:0741-5214
1097-6809
DOI:10.1067/mva.2001.117885