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Single-center prospective, randomized analysis of conventional and eversion carotid endarterectomy
D M Markovic1, L B Davidovic, D D Cvetkovic
1Clinic for Vascular Surgery, Institute for Cardiovascular Diseases, Clinical Center of Serbia, Belgrade, Serbia.
The Journal of Cardiovascular Surgery
|August 2, 2008
Summary
Eversion carotid endarterectomy (EEA) shows a lower restenosis rate compared to conventional carotid endarterectomy (CEA). However, CEA may be preferred when shunting is necessary during the procedure.
Area of Science:
- Vascular Surgery
- Cerebrovascular Disease Management
Background:
- Choosing between conventional carotid endarterectomy (CEA) and eversion carotid endarterectomy (EEA) remains challenging.
- Surgical technique choice often relies on surgeon experience rather than comparative outcomes.
Purpose of the Study:
- To compare the early and long-term results of eversion carotid endarterectomy (EEA) versus conventional carotid endarterectomy (CEA).
Main Methods:
- A randomized study involving 103 patients for EEA and 98 for CEA.
- Patients included asymptomatic and symptomatic individuals with carotid artery lesions.
- Outcomes assessed included mortality, neurological complications, survival rates, and restenosis incidence.
Main Results:
- Mean follow-up was 38 months; mortality and survival rates were similar between groups.
- Perioperative central neurological complications were comparable (3.9% vs 12.1%).
- Late restenosis incidence was significantly lower in the EEA group (0.0% vs 6.1%).
Conclusions:
- Eversion carotid endarterectomy (EEA) demonstrates an advantage due to lower late restenosis rates.
- Conventional carotid endarterectomy (CEA) is recommended when intraoperative shunting is indicated by low retrograde pressure.