Eversion versus conventional carotid endarterectomy: A retrospective cohort study

This study evaluated the effectiveness of the eversion technique in improving surgical outcomes and patient safety during carotid endarterectomy (CEA). This retrospective study included patients who underwent isolated carotid endarterectomy between 2015 and 2024 at the Cardiovascular Surgery Clinic of Karadeniz Technical University. A total of 207 carotid endarterectomy patients were evaluated, comparing the conventional carotid endarterectomy (C-CEA) technique with the eversion carotid endarterectomy (E-CEA) technique. Patch utilization rates, cross-clamping, and operation times were evaluated and compared, along with mortality and morbidity outcomes, including postoperative cerebrovascular events, death, myocardial infarction, and peripheral nerve injury. Preoperative demographic characteristics were similar between the 2 groups. Perioperative cross-clamp and operation times were significantly shorter in the E-CEA group. Additionally, no patch was used in any patient in the E-CEA group, contributing to shorter operation times and eliminating the need for an additional incision for the saphenous patch. Eversion carotid endarterectomy yields similar outcomes to conventional carotid endarterectomy in terms of stroke, mortality, perioperative myocardial infarction, and local nerve injury. However, E-CEA demonstrated statistical superiority in operation and cross-clamp times, and the need for patching. Although randomized prospective studies with larger patient populations are necessary for more definitive conclusions, E-CEA appears to be a safe and effective alternative to C-CEA.