Elliptical transection for eversion endarterectomy enables efficient external carotid artery desobliteration

Area of Science:

• Vascular Surgery
• Cardiovascular Medicine
• Surgical Techniques

Background:

• Eversion endarterectomy (EEA) offers reduced surgical exposure compared to conventional methods.
• Contradictory results exist regarding EEA's technical success, particularly for external carotid artery (ECA) patency.

Purpose of the Study:

• To evaluate the impact of elliptical EEA on the quality and outcome of ECA desobliteration.
• To assess ECA patency rates following elliptical EEA.

Main Methods:

• A prospective study evaluated 30 patients undergoing EEA via a short transverse incision.
• Patients received either general anesthesia (GA) or locoregional anesthesia (LRA).
• Clinical outcomes and carotid disease progression were assessed at one year.

Main Results:

• No postoperative strokes, nerve damage, or deaths occurred.
• Ipsilateral ECA stenosis >50% decreased from 64% preoperatively to 16% at one year (P<0.001).
• Overall ECA patency at one year was 96.7%, with no significant difference between GA and LRA groups.

Conclusions:

• Elliptical EEA facilitates excellent ECA revascularization and maintains good patency at one year.
• The choice of anesthesia (GA or LRA) does not influence the effectiveness of the eversion technique.