Comparison of Results Classical and Eversion Carotid Endarterectomy

Area of Science:

• Vascular Surgery
• Neurology
• Cardiology

Background:

• Atherosclerosis of extra-cranial and intra-cranial arteries is a primary cause of cerebrovascular events.
• Carotid endarterectomy (CEA) is a crucial preventive surgical procedure to mitigate stroke risk.
• Two primary CEA techniques exist: eversion carotid endarterectomy (E-CEA) and classical carotid endarterectomy (C-CEA).

Purpose of the Study:

• To compare the perioperative results of E-CEA versus C-CEA.
• To evaluate the incidence of postoperative complications associated with each CEA technique.

Main Methods:

• A retrospective-prospective study involving 173 patients with carotid stenosis undergoing CEA from December 2013 to December 2016.
• Patients were divided into two groups: 90 treated with E-CEA and 83 with C-CEA.

Main Results:

• E-CEA group demonstrated significantly shorter surgery duration (92.56 min vs. 104.04 min), carotid clamping time (11.83 min vs. 23.69 min), and reduced postoperative drainage (25.33 ml vs. 36.14 ml).
• Patients undergoing E-CEA had shorter intensive care unit (ICU) stays (25.43 hours vs. 34.54 hours) and overall hospital length of stay (4.60 days vs. 5.42 days).
• While individual complication rates were not statistically significant, the overall postoperative complication rate was significantly lower in the E-CEA group (7.77% vs. 18.7%).

Conclusions:

• The E-CEA technique is associated with superior perioperative outcomes compared to C-CEA for carotid artery treatment.
• E-CEA demonstrates a favorable profile regarding surgical time, clamping duration, drainage, ICU stay, and overall complications.
• The findings support the broader adoption of the E-CEA technique in the surgical management of carotid stenosis.