Related Experiment Video
Updated: Aug 25, 2025
Optimization of the Longa Middle Cerebral Artery Occlusion Method for Complete Reperfusion
Published on: November 22, 2024
Primary arterial closure after carotid endarterectomy is a safe and expeditious technique in appropriately selected
Yazen Qumsiyeh1, Leigh Ann O'Banion1, Rachel Dirks1
1Department of Surgery, University of California San Francisco, Fresno, CA, USA.
Background:
Carotid endarterectomy (CEA) remains a safe and durable operation for both symptomatic and asymptomatic carotid stenosis, however conflicting evidence exists on the benefit of patch angioplasty and its effects on post-operative outcomes.
Methods:
A retrospective review of all patients undergoing CEA from 2011 to 2018 was performed.
Results:
Of 851 patients, primary closure was performed in 277 (33%). Patients with primary closure were older (74 vs 72, p = 0.001), symptomatic (39% vs 34%, p = 0.024), and male (69% vs 31% p < 0.001), with a higher incidence of diabetes mellitus (47% vs 39%, p = 0.046) and ESRD (4% vs 2%, p = 0.015). Restenosis rates were similar (7% vs 8%, p = 0.67). Operative time was shorter for primary closure (87 ± 28 vs 102 ± 26 min, p < 0.001). There were no differences in 30-day ipsilateral stroke rates (1% vs 1%, p = 0.51) or stroke-free survival.
Conclusions:
Primary arterial closure is safe and expeditious in appropriately selected high-risk patients.
