Partial Eversion Carotid Endarterectomy versus Conventional Techniques for Significant Carotid Stenosis.

Area of Science:

• Vascular Surgery
• Cerebrovascular Disease Management
• Surgical Outcomes Research

Background:

• Significant carotid stenosis poses a risk for stroke.
• Carotid endarterectomy (CEA) is a primary surgical intervention.
• Different CEA techniques exist, including partial (P-CEA), conventional with patch closure (C-CEA), and eversion (E-CEA).

Purpose of the Study:

• To compare the clinical outcomes of partial carotid endarterectomy (P-CEA).
• To evaluate P-CEA against standard conventional CEA with patch closure (C-CEA) and eversion CEA (E-CEA).
• To assess short-term and long-term efficacy and safety of these CEA techniques.

Main Methods:

• Retrospective analysis of 327 patients undergoing CEA between January 2014 and December 2018.
• Primary outcomes: 30-day and follow-up mortality, neurologic and cardiologic complications.
• Secondary outcomes: perioperative local complications and restenosis rates.

Main Results:

• No significant differences in 30-day or follow-up neurologic complications among P-CEA, C-CEA, and E-CEA groups.
• Perioperative local complications were also statistically similar across the three surgical techniques.
• 202 patients (61.8%) underwent P-CEA, 103 (31.5%) C-CEA, and 22 (6.7%) E-CEA.

Conclusions:

• Partial carotid endarterectomy (P-CEA) demonstrates similar perioperative and long-term outcomes compared to C-CEA and E-CEA.
• Rates of mortality, neurologic, cardiologic, and local complications are comparable across all three CEA methods.
• Restenosis rates were also similar in the long-term follow-up for P-CEA, C-CEA, and E-CEA.