Related Experiment Video
Updated: May 1, 2026
Surgical Technique for the Implantation of Tissue Engineered Vascular Grafts and Subsequent In Vivo Monitoring
Published on: April 3, 2015
Comparison of two surgical techniques for carotid endarterectomy: conventional and eversion
1Ataturk Training and Research Hospital, Katip Celebi University, Izmir, Turkey.
Insights
Eversion carotid endarterectomy (E-CEA) shows comparable durability and safety to conventional carotid endarterectomy (C-CEA) for atherosclerotic carotid disease, with similar restenosis rates and fewer complications.
Area of Science:
- Vascular Surgery
- Cardiovascular Disease
- Surgical Techniques
Background:
- Carotid endarterectomy is established for atherosclerotic carotid bifurcation disease.
- Comparing eversion carotid endarterectomy (E-CEA) to conventional carotid endarterectomy (C-CEA) is crucial for understanding long-term outcomes.
Purpose of the Study:
- To compare the durability and safety of E-CEA versus C-CEA.
- To evaluate postoperative complications, including death, stroke, and restenosis, between the two surgical methods.
Main Methods:
- Retrospective analysis of 380 consecutive primary carotid endarterectomies (CEAs) performed between March 2003 and November 2012.
- 202 patients underwent C-CEA, and 178 patients underwent E-CEA.
- Carotid duplex ultrasonography was used for follow-up at 1, 6, 12, and 24 months post-surgery.
Main Results:
- Mean follow-up was 26 months. Postoperative stroke rates were low in both groups (1 in E-CEA, 2 in C-CEA).
- Restenosis rates at follow-up were similar: 2.24% for E-CEA and 2.97% for C-CEA.
- Mean cross-clamping time was shorter for E-CEA (9.54 min) compared to C-CEA (12.62 min), though not statistically significant (P=0.236).
Conclusions:
- Both E-CEA and C-CEA are effective surgical options for carotid artery disease.
- E-CEA presents potential advantages and should be considered an alternative surgical approach.
- Classical endarterectomy remains a gold standard, but eversion technique warrants consideration.
Background:
The role of carotid endarterectomy for the treatment of atherosclerotic carotid bifurcation disease is now well established. The aim of this study was to compare durability, postoperative death, stroke, minor strokes, cranial nerve injuries, neck hematomas, myocardial infarctions, or surgical defects and restenosis at the operative site following short- and mid-term duration of the advantages eversion carotid endarterectomy (E-CEA) compared to conventional carotid endarterectomy (C-CEA).
Patients And Methods:
Between March 2003 and November 2012, primary CEAs were performed in 380 consecutive patients by the same surgical groups. These patients were evaluated retrospectively. C-CEA was performed in 202 patients, and E-CEA was performed in 178 patients. Carotid duplex ultrasonography was performed in all patients at 1, 6, 12 and 24 months after CEA to identify residual atherosclerotic carotid disease.
Results:
Mean age was 67.3±13.4 years in the E-CEA group and 64.8±14.8 years in the C-CEA group. Mean cross-clamping time in the E-CEA group was 9.54±2.6 minutes and 12.62±2.7 minutes for C-CEA group (P=0.236). Three postoperative strokes occurred (one after E-CEA and two after C-CEA). In the E-CEA group and C-CEA group respectively, carotid stenosis rates were found in 4 patients (2.24%) and in 5 (2.97%) at a follow-up period of 26 months.
Conclusion:
Classical endarterectomy still remains the gold standard surgical technique for patients who are selected for coronary artery disease surgery. Nevertheless, we believe that eversion endarterectomy, which has some advantages, must be kept in mind as an alternative approach.
More Related Videos
15:21Training a Sophisticated Microsurgical Technique: Interposition of External Jugular Vein Graft in the Common Carotid Artery in Rats
Published on: November 11, 2012
13:18Optimization of the Longa Middle Cerebral Artery Occlusion Method for Complete Reperfusion
Published on: November 22, 2024
