Microsurgical interintimal dissection in carotid endarterectomy.

Area of Science:

• Vascular Surgery
• Cerebrovascular Disease
• Surgical Pathology

Background:

• Complete carotid plaque excision in carotid endarterectomy (CEA) is crucial for preventing stroke and restenosis.
• Carotid atherosclerosis pathology guides surgical dissection planes.
• Inner-intimal dissection is presented as a novel approach for CEA.

Purpose of the Study:

• To evaluate the efficacy of inner-intimal dissection in carotid endarterectomy.
• To assess the safety and completeness of plaque resection using this technique.
• To analyze the pathological findings and surgical outcomes of inner-intimal dissection in CEA.

Main Methods:

• Inner-intimal dissection of thickened intima under high-magnification microscopy.
• Slicing the intima to achieve complete plaque resection with a smooth distal edge.
• Pathological examination of excised carotid plaque specimens.

Main Results:

• Sixty-three carotid endarterectomies were performed on 61 patients with carotid stenosis.
• Complete plaque resection without tacking sutures was achieved in all cases.
• No mortality, 1.6% minor stroke rate, and no early restenosis observed during follow-up.

Conclusions:

• Microsurgical interintimal dissection facilitates complete carotid plaque excision.
• This technique leads to favorable surgical outcomes, including the absence of significant early restenosis.
• Inner-intimal dissection is a safe and effective method for carotid endarterectomy.