Retrojugular approach for carotid endarterectomy: A prospective cohort study

• Published in: Journal of vascular surgery 2002-04, Vol.35 (4), p.737-740
• Main Authors: Safar, H.A., Doobay, B., Evans, G., Kazemi, K., Jahromi, A., Cinà, C.S.
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Case-Control Studies; Cohort Studies; Endarterectomy, Carotid - methods; Female; Humans; Intraoperative Care; Length of Stay - statistics & numerical data; Male; Medical sciences; Neurosurgery; Postoperative Complications - epidemiology; Prospective Studies; Skull, brain, vascular surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Time Factors
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1067/mva.2002.121121

The purpose of this study was the examination of the feasibility of the retrojugular approach for carotid endarterectomy and the investigation of its safety and effectiveness. A consecutive prospective cohort of 43 patients who underwent carotid endarterectomy with the retrojugular approach was compared with a retrospective cohort of 43 patients who underwent surgery with the standard antejugular technique. Age, sex, comorbidity, diagnostic investigations, and indications for surgery were comparable in both groups. In the retrojugular group, a carotid shunt was used in 18 patients (42%) and a patch closure in 15 patients (35%), and in the antejugular group, a carotid shunt was used in 43 patients (100%) and a patch closure in 20 patients (47%). There were no perioperative deaths, strokes, nerve injuries, or 30-day postoperative neurologic events. Wound hematomas were equally distributed in both groups (5%). Transient hoarseness was present in two patients in the antejugular group. The mean operative time was 72 ± 15 minutes for the retrojugular technique and 100 ± 27 for the antejugular technique (P