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The modified operative technique of partial eversion carotid endarterectomy.
Richard McBride1, Johnathan Porter1, Haytham Al-Khaffaf1
1Department of Vascular Surgery, Royal Blackburn Hospital, Blackburn, United Kingdom.
Journal of Vascular Surgery
|December 25, 2016
Summary
Partial eversion carotid endarterectomy (PECE) is a modified surgical technique. This study shows PECE offers comparable outcomes to standard methods with reduced operative and clamping times.
Area of Science:
- Vascular Surgery
- Surgical Techniques
- Cerebrovascular Disease
Background:
- Carotid endarterectomy is a common procedure for preventing stroke.
- Optimizing surgical techniques can improve patient outcomes and reduce complications.
Purpose of the Study:
- To report a modified operative technique, partial eversion carotid endarterectomy (PECE).
- To evaluate the safety and efficacy of PECE in a large patient cohort.
Main Methods:
- A 9-year retrospective review (2006-2015) of 352 patients undergoing PECE.
- Data collection included indications, intraoperative details, and postoperative outcomes.
- Carotid duplex ultrasound imaging was performed at various intervals post-surgery.
Main Results:
- Indications included stroke, transient ischemic attack, amaurosis fugax, asymptomatic disease, and pre-cardiac surgery.
- Median clamp time was 14 minutes and total operation time was 41 minutes.
- 30-day outcomes included 1.2% TIAs, 1.4% strokes, and 0.5% deaths, with no significant cranial nerve injuries or restenosis.
Conclusions:
- Partial eversion carotid endarterectomy (PECE) is technically straightforward.
- PECE demonstrates outcomes comparable to current techniques.
- Advantages include reduced operative and carotid clamping times.
