High Mini-Skin Incision during Carotid Endarterectomy for Carotid Stenosis

Area of Science:

• Vascular Surgery
• Neurosurgery
• Surgical Innovation

Background:

• Carotid endarterectomy (CEA) treats carotid stenosis, a condition linked to stroke and neurological deficits.
• Minimizing incision size in CEA aims to reduce complications and enhance aesthetic outcomes.
• Conventional longitudinal incisions are standard, but smaller incisions are being explored.

Purpose of the Study:

• To compare the outcomes of CEA using high mini-skin incisions (HMIs) versus conventional incisions.
• To evaluate short-term postoperative results, including stroke, TIA, and nerve injury rates.
• To identify risk factors for nerve injury in CEA procedures.

Main Methods:

• Retrospective analysis of 151 CEA cases (110 conventional, 41 HMI) from March 2015 to December 2021.
• Evaluation of 30-day postoperative mortality, stroke, TIA, and cranial/cervical nerve injury rates.
• Assessment of risk factors associated with nerve injuries.

Main Results:

• The HMI group demonstrated significantly shorter operative and clamp times (p<0.01).
• Incision length was significantly shorter in the HMI group (5.3±0.9 cm) compared to the conventional group (11.5±2.8 cm).
• No significant differences in 30-day stroke, TIA, death, or transient nerve injury rates were observed between groups. High lesion level and clamp time were identified as risk factors for nerve injury.

Conclusions:

• High mini-skin incisions (HMIs) offer advantages in CEA, including reduced operative and clamp times.
• HMIs lead to improved esthetic outcomes and comparable safety profiles regarding neurologic complications.
• This technique represents a beneficial advancement for carotid endarterectomy procedures.