Eversion endarterectomy in surgery of the internal carotid artery

A total of 361 eversion endarterectomies of the internal carotid artery have been carried out on 348 patients between January 1991 and December 1992. Of these patients, 126 were women and 222 were men; average age was 62.9 (range 42-84) years. Some 239 patients had hemispheric symptoms; 37 symptomless patients had a carotid endarterectomy before major vascular reconstruction, and 21 had the operation combined with heart surgery (19 aortocoronary bypasses, two valve replacements). In nine cases (2.5%) a 6-mm interposition graft was used because of unsuccessful eversion endarterectomy. Postoperative bleeding occurred in six patients (1.7%) and postoperative stroke in seven (1.9%); of these patients, four died and two still have mild neurological symptoms. Four reocclusions occurred during the first 6 months that the new method was used. Eversion endarterectomy of the internal carotid artery is a safe and useful technique and is comparable with standard endarterectomies. This technique may reduce the risk of restenosis.