• Ir J Med Sci · Feb 2020

    A comparison of outcomes of eversion versus conventional carotid endarterectomy: one centre experience.

    • Seán C Maguire, Mohamed Elnagar, Afia Nazar, and Stephen J Sheehan.
    • Department of Vascular Surgery, St Vincent's University Hospital, Dublin, Ireland. semaguir@tcd.ie.
    • Ir J Med Sci. 2020 Feb 1; 189 (1): 103-108.

    IntroductionPrompt carotid endarterectomy for stroke prevention remains an essential component of treatment for symptomatic carotid stenosis. There exist a number of techniques, most commonly, access via a longitudinal arteriotomy for conventional carotid endarterectomy (CCEA), but eversion endarterectomy (ECEA) may also be used. Neither has been definitively proven as superior. We outline the experience in our institution of these two approaches.MethodsAll patients who had surgery over a 7-year period (2009-2015) under a single consultant vascular surgeon were included in this analysis. Midway through the study period, the operative technique was changed from exclusively CCEA to exclusively ECEA. Demographics, outcomes, and complications, including re-intervention and restenosis rate were gathered from a variety of sources to maximise data reliability and accuracy.ResultsTwo hundred four interventions were performed during the study period; 114 in the CCEA group, 90 in the ECEA group. Demographics and indication for surgery was well matched between groups. A significant difference was found between operative time (128.6 ± 2.3 vs 70.7 ± 12.2 min) and need for shunting (19.3% vs 1.9%), between CCEA and ECEA. Haematoma rates were higher in the ECEA group (7.7% vs 1.7%), but this can be attributed to differing use of perioperative anti-platelet therapy. There was no other statistical difference in morbidity, mortality, restenosis rates, or re-intervention rates between groups.ConclusionThese two carotid endarterectomy techniques are equivalent in terms of outcome, but ECEA can be performed in a significantly shorter operative time and reduces need for shunting.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…