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Related Experiment Videos

Carotid endarterectomy by eversion technique: its safety and durability

D M Shah1, R C Darling, B B Chang

  • 1Division of Vascular Surgery, Center for Vascular Disease, Albany Medical College, New York 12208, USA.

Annals of Surgery
|October 28, 1998
PubMed
Summary

Eversion carotid endarterectomy (CEA) offers a safe alternative to standard CEA, demonstrating lower stroke, death, and restenosis rates. This technique simplifies closure, potentially improving patient outcomes in carotid artery disease management.

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Area of Science:

  • Vascular Surgery
  • Cerebrovascular Surgery
  • Surgical Outcomes

Background:

  • Standard carotid endarterectomy (CEA) outcomes are measured by neurologic function preservation and restenosis rates.
  • Patch closure after CEA may increase restenosis risk.
  • Eversion CEA offers direct visualization and avoids patch closure.

Purpose of the Study:

  • To compare the safety and efficacy of eversion CEA versus standard CEA.
  • To evaluate operative mortality, neurologic deficits, and restenosis rates.
  • To assess the long-term outcomes of eversion CEA.

Main Methods:

  • A retrospective review of 2249 eversion CEAs and 474 standard CEAs performed between May 1993 and March 1998.
  • Most procedures were performed under regional anesthesia in awake patients.

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  • Duplex ultrasound follow-up was utilized for restenosis assessment.

    • Main Results:

    • Eversion CEA had a lower operative mortality (1.02% vs. 2.2%) and fewer permanent neurologic deficits (0.8% vs. 2.3%) compared to standard CEA.
    • Restenosis rates greater than 60% were lower in the eversion group (0.3% vs. 1.1%).
    • Transient neurologic deficits were also lower in the eversion group (0.9% vs. 2.7%).

    Conclusions:

    • Eversion CEA is a safe and effective technique for carotid artery disease.
    • It is associated with reduced rates of stroke, death, and restenosis.
    • The technique provides favorable short- and long-term outcomes.