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Long-term results of eversion carotid endarterectomy
James H Black1, Joseph J Ricotta, Calvin E Jones
1Division of Vascular and Endovascular Surgery, Johns Hopkins Hospital, Baltimore, MD 21287, USA. jhblack@jhmi.edu
Annals of Vascular Surgery
|September 8, 2009
Summary
Eversion carotid endarterectomy (ECEA) is a safe and durable treatment for carotid stenosis, showing low complication rates and long-term effectiveness in patients with or without symptoms. This study provides the longest follow-up data for ECEA.
Area of Science:
- Vascular Surgery
- Cerebrovascular Disease
- Surgical Outcomes
Background:
- Carotid endarterectomy (CEA) is the standard for carotid stenosis.
- Eversion CEA (ECEA) is an alternative technique with limited long-term data.
- This study evaluates the long-term durability of ECEA.
Purpose of the Study:
- To analyze the long-term durability of Eversion Carotid Endarterectomy (ECEA).
- To assess the incidence of major adverse cardiovascular events (MACEs) and late outcomes after ECEA.
- To determine the rate and predictors of carotid restenosis following ECEA.
Main Methods:
- Prospective data collection from 534 ECEAs (1989-2002) on 485 patients.
- Retrospective review to determine 30-day MACEs, late survival, and ipsilateral carotid disease.
- Statistical analysis of variables associated with carotid restenosis.
Main Results:
- Mean follow-up of 8.86 years.
- 3.8% MACE rate (2.6% stroke, 1.2% death); <30-day complication rate of 5.3%.
- 4.1% restenosis rate at a mean of 4.4 years; no specific risk factors predicted restenosis.
Conclusions:
- Eversion Carotid Endarterectomy (ECEA) is a safe and durable procedure.
- ECEA demonstrates long-term effectiveness for symptomatic and asymptomatic extracranial carotid disease.
- This study provides the longest follow-up data supporting ECEA's efficacy.
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