Comparative Results of Conventional and Eversion Carotid Endarterectomy

Overview

Journal Ann Surg Treat Res

Specialty General Surgery

Date 2014 Oct 16

PMID 25317414

Citations 3

Authors

Jae Hoon Lee

Bo Yang Suh

Affiliations

Soon will be listed here.

Abstract

Purpose: Comparative results of conventional carotid endarterectomy (cCEA) and eversion carotid endarterectomy (eCEA) have been reported in many studies. But in Korea, there have been no reports to compare the outcome of the two techniques. Thus, we investigated the results of eCEA compared to cCEA in Yeungnam University Medical Center.

Methods: A total of 120 subjects who underwent CEA were included in this study. Of them, cCEAs were performed in 63 patients and eCEAs were performed in 57 patients. We analyzed the results divided into the early (within 30 days after surgery), midterm (from 30 days up to 1 year after surgery) and late (over 1 year after surgery).

Results: Mean age of the patients was 65.9 ± 7.1 years in cCEA group and 66.8 ± 7.7 years in eCEA group (P = 0.523). Carotid shunt frequency was higher in the cCEA group (39.7% vs. 19.3%, P = 0.015). There were no statistical differences in the early complications with the exception of a significantly higher risk for new brain lesions in the cCEA group (34.9% vs. 14.0%, P = 0.008). The frequency of complication was same between cCEA group and eCEA group in the midterm. Although there was no statistical significance, the frequency of late complications was higher in the cCEA group compared to eCEA group. Mean follow-up duration was 29.4 ± 23.5 months.

Conclusion: These data showed that eCEA was an acceptable procedure and had some advantage compared to cCEA in the aspect of the early and late complication.

Citing Articles

Does the eversion technique have a lower early postoperative stroke rate than the conventional technique in carotid endarterectomy?.

Rahim A, Elsamani K, Galal A, Hammoda M, Mittapalli D Ann Med Surg (Lond). 2022; 81:104505.

PMID: 36147067 PMC: 9486758. DOI: 10.1016/j.amsu.2022.104505.

Comparison of Results Classical and Eversion Carotid Endarterectomy.

Djedovic M, Mujanovic E, Hadzimehmedagic A, Totic D, Vukas H, Vranic H Med Arch. 2017; 71(2):89-92.

PMID: 28790536 PMC: 5511541. DOI: 10.5455/medarh.2017.71.89-92.

Carotid Endarterectomy in the Southern California Vascular Outcomes Improvement Collaborative.

Chan K, Abouzamzam A, Woo K Ann Vasc Surg. 2017; 42:11-15.

PMID: 28323231 PMC: 5559870. DOI: 10.1016/j.avsg.2016.11.007.

References

Cao P, Giordano G, de Rango P, Zannetti S, Chiesa R, Coppi G . A randomized study on eversion versus standard carotid endarterectomy: study design and preliminary results: the Everest Trial. J Vasc Surg. 1998; 27(4):595-605. DOI: 10.1016/s0741-5214(98)70223-x. View

DE BAKEY M, Crawford E, Cooley D, MORRIS Jr G . Surgical considerations of occlusive disease of innominate, carotid, subclavian, and vertebral arteries. Ann Surg. 1959; 149(5):690-710. PMC: 1451085. DOI: 10.1097/00000658-195905000-00010. View

Rothwell P, Slattery J, Warlow C . Clinical and angiographic predictors of stroke and death from carotid endarterectomy: systematic review. BMJ. 1998; 315(7122):1571-7. PMC: 2127967. DOI: 10.1136/bmj.315.7122.1571. View

Barnett H, Taylor D, Haynes R, Sackett D, Peerless S, Ferguson G . Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. N Engl J Med. 1991; 325(7):445-53. DOI: 10.1056/NEJM199108153250701. View

Shah D, Darling 3rd R, Chang B, Paty P, Kreienberg P, Lloyd W . Carotid endarterectomy by eversion technique: its safety and durability. Ann Surg. 1998; 228(4):471-8. PMC: 1191519. DOI: 10.1097/00000658-199810000-00004. View

Antonopoulos C, Kakisis J, Sergentanis T, Liapis C . Eversion versus conventional carotid endarterectomy: a meta-analysis of randomised and non-randomised studies. Eur J Vasc Endovasc Surg. 2011; 42(6):751-65. DOI: 10.1016/j.ejvs.2011.08.012. View

Eastcott H, PICKERING G, ROB C . Reconstruction of internal carotid artery in a patient with intermittent attacks of hemiplegia. Lancet. 1954; 267(6846):994-6. DOI: 10.1016/s0140-6736(54)90544-9. View

Sadideen H, Taylor P, Padayachee T . Restenosis after carotid endarterectomy. Int J Clin Pract. 2006; 60(12):1625-30. DOI: 10.1111/j.1742-1241.2005.00775.x. View

Biller J, Feinberg W, Castaldo J, Whittemore A, Harbaugh R, Dempsey R . Guidelines for carotid endarterectomy: a statement for healthcare professionals from a Special Writing Group of the Stroke Council, American Heart Association. Circulation. 1998; 97(5):501-9. DOI: 10.1161/01.cir.97.5.501. View

10.

Kasprzak P, Raithel D . [Eversion endarterectomy of the internal carotid artery]. Vasa Suppl. 1992; 37:83-4. View

11.

Lanzino G, Rabinstein A, Brown Jr R . Treatment of carotid artery stenosis: medical therapy, surgery, or stenting?. Mayo Clin Proc. 2009; 84(4):362-87. PMC: 2665982. DOI: 10.1016/S0025-6196(11)60546-6. View

12.

Petty G, Brown Jr R, Whisnant J, Sicks J, OFallon W, Wiebers D . Ischemic stroke subtypes: a population-based study of incidence and risk factors. Stroke. 1999; 30(12):2513-6. DOI: 10.1161/01.str.30.12.2513. View

13.

Paciaroni M, Eliasziw M, Kappelle L, Finan J, Ferguson G, Barnett H . Medical complications associated with carotid endarterectomy. North American Symptomatic Carotid Endarterectomy Trial (NASCET). Stroke. 1999; 30(9):1759-63. DOI: 10.1161/01.str.30.9.1759. View

14.

ETHEREDGE S . A simple technic for carotid endarterectomy. Am J Surg. 1970; 120(2):275-8. DOI: 10.1016/s0002-9610(70)80124-6. View

15.

Demirel S, Attigah N, Bruijnen H, Ringleb P, Eckstein H, Fraedrich G . Multicenter experience on eversion versus conventional carotid endarterectomy in symptomatic carotid artery stenosis: observations from the Stent-Protected Angioplasty Versus Carotid Endarterectomy (SPACE-1) trial. Stroke. 2012; 43(7):1865-71. DOI: 10.1161/STROKEAHA.111.640102. View

16.

Chaturvedi S, Bruno A, Feasby T, Holloway R, Benavente O, Cohen S . Carotid endarterectomy--an evidence-based review: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2005; 65(6):794-801. DOI: 10.1212/01.wnl.0000176036.07558.82. View

17.

Young B, Moore W, Robertson J, Toole J, Ernst C, Cohen S . An analysis of perioperative surgical mortality and morbidity in the asymptomatic carotid atherosclerosis study. ACAS Investigators. Asymptomatic Carotid Atherosclerosis Study. Stroke. 1996; 27(12):2216-24. DOI: 10.1161/01.str.27.12.2216. View

18.

Connolly J . The evolution of extracranial carotid artery surgery as seen by one surgeon over the past 40 years. Surgeon. 2004; 1(5):249-58. DOI: 10.1016/s1479-666x(03)80040-9. View

19.

Cao P, Giordano G, de Rango P, Zannetti S, Chiesa R, Coppi G . Eversion versus conventional carotid endarterectomy: late results of a prospective multicenter randomized trial. J Vasc Surg. 2000; 31(1 Pt 1):19-30. DOI: 10.1016/s0741-5214(00)70064-4. View

20.

Peiper C, Nowack J, Ktenidis K, Reifenhauser W, Keresztury G, Horsch S . Eversion endarterectomy versus open thromboendarterectomy and patch plasty for the treatment of internal carotid artery stenosis. Eur J Vasc Endovasc Surg. 1999; 18(4):339-43. DOI: 10.1053/ejvs.1999.0912. View