[Discussion on the technical standards for quality of life-modified eversion carotid endarterectomy]

Ischemic stroke caused by carotid stenosis has become a significant societal burden. The treatment of carotid artery stenosis serves as an effective strategy for stroke prevention, for which carotid endarterectomy (CEA) is considered the gold standard. However, in clinical practice, certain limitations were observed in traditional carotid endarterectomy (CEA) regarding the reduction of perioperative complication risks and the assurance of mid-to long-term efficacy. Therefore, exploration of modifications to the CEA technique held substantial practical significance. Our center proposed the quality of life-modified eversion carotid endarterectomy (QCEA). The key technical modifications included: making an oblique arteriotomy at approximately a 60° angle relative to the bifurcation plane, shaping the arterial anastomosis through longitudinal trimming and remodeling it into a trumpet-shaped orifice, and employing a minimally invasive cosmetic transverse incision along the natural skin lines.