The comparison of the postoperative complications, mortality, and morbidity of the eversion technique and the classical technique in carotid endarterectomy
Abstract views: 178
/ 
PDF downloads: 133
DOI:
https://doi.org/10.26900/hsq.2066Keywords:
Carotid Endarterectomy, eversion, strokeAbstract
In the present study, the purpose was to compare the postoperative early and mid-term results of Eversion Carotid Endarterectomy (ECEA) and Classical Carotid Endarterectomy (CCEA) techniques used in the surgical treatment of carotid artery disease. A total of 269 patients who underwent carotid endarterectomy (105 ECEA and 164 CCEA) were included in the study. The 1st, 6th, and 12th-month follow-ups of 266 patients were performed because three patients died in the early postoperative period. All patients were started on acetylsalicylic acid, clopidogrel, and statin treatment in the postoperative period. When the postoperative results were evaluated, it was found that the cross-clamp and operation times of the surgeries performed with the ECEA technique were shorter than the CCEA
at statistically significant levels (p=0.0002). Although there statistically significant differences were detected in terms of bleeding/drainage, need for reoperation because of bleeding, and restenosis, ECEA had more positive results than CCEA, and there were no statistically and proportionally significant differences between the two methods in terms of postoperative stroke and mortality. Considering the experience of the surgical team, the use of the ECEA technique has more positive results in terms of operation time and cross-clamp time compared to CCEA. We think that extending the follow-up periods of patients in the postoperative period and conducting multicenter studies with more patients would be more accurate in comparing these two methods.
Downloads
References
Strandness DE, Eikelboom BC. Carotid artery stenosis--where do we go from here? Eur J Ultrasound. 1998;7(3):S17-S26. doi: 10.1016/s0929-8266(98)00025-1.
Carotid artery diseases. In: Bozkurt AK, editor. National treatment guide of peripheral arterial and venous disease. 1. İstanbul: Baycinar medical publisher; 2021. 100-30 p.
O’Holleran LW, Kennelly MM, McClurken M, Johnson JM. Natural history of asymptomatic carotid plaque. Five year follow-up study. Am J Surg. 1987;154(6):659-62. doi: 10.1016/0002-9610(87)90238-8.
Naylor AR. More unites us than divides us. J Vasc Surg. 2022;75(1):2S-3S. doi: 10.1016/j.jvs.2021.05.037.
Naylor AR, Ricco JB, de Borst GJ, Debus S, de Haro J, Halliday A, et al. Editor’s Choice - Management of Atherosclerotic Carotid and Vertebral Artery Disease: 2017 Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg. 2018;55(1):3-81. doi: 10.1016/j.ejvs.2017.06.021.
Cao P, De Rango P, Cieri E, Giordano G. Eversion versus conventional endarterectomy. Semin Vasc Surg. 2004;17(3):236-42. doi:10.1016/s0895-7967(04)00050-x.
Cui L, Han Y, Zhang S, Liu X, Zhang J. Safety of stenting and endarterectomy for asymptomatic carotid artery stenosis: a meta-analysis of randomised controlled trials. Eur J Vasc Endovasc Surg. 2018;55(5):614-24. doi: 10.1016/j.ejvs.2018.02.020.
Adams HP Jr, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke. 1993;24(1):35-41. doi:10.1161/01.str.24.1.35.
Cao P, Giordano G, De Rango P, Caporali S, Lenti M, Ricci S, et al. Eversion versus conventional carotid endarterectomy: a prospective study. Eur J Vasc Endovasc Surg. 1997;14(2):96-104. doi:10.1016/s1078-5884(97)80204-3.
Schneider JR, Helenowski IB, Jackson CR, Verta MJ, Zamor KC, Patel NH, et al. A comparison of results with eversion versus conventional carotid endarterectomy from the vascular quality initiative and the Mid-America vascular study group. J Vasc Surg. 2015;61(5):1216-22. doi:10.1016/j.jvs.2015.01.049.
Paraskevas KI, Robertson V, Saratzis AN, Naylor AR. Editor’s Choice - An updated systematic review and meta-analysis of outcomes following eversion vs. conventional carotid endarterectomy in randomised controlled trials and observational studies. Eur J Vasc Endovasc Surg. 2018;55(4):465-73. doi: 10.1016/j.ejvs.2017.12.025.
Cao P, Giordano G, De Rango P, Zannetti S, Chiesa R, Coppi G, et al. A randomized study on eversion versus standard carotid endarterectomy: study design and preliminary results: the Everest Trial. J Vasc Surg. 1998;27(4):595- 605. doi: 10.1016/s0741-5214(98)70223-x.
Cao P, Giordano G, De Rango P, Zannetti S, Chiesa R, Coppi G, et al. Eversion versus conventional carotid endarterectomy: late results of a prospective multicenter randomized trial. J Vasc Surg. 2000;31(1):19-30. doi: 10.1016/s0741-5214(00)70064-4.
Cao P, De Rango P, Zannetti S. Eversion vs conventional carotid endarterectomy: a systematic review. Eur J Vasc Endovasc Surg. 2002;23(3):195-201. doi: 10.1053/ejvs.2001.1560.
Dakour-Aridi H, Ou M, Locham S, AbuRahma A, Schneider JR, Malas M. Outcomes following eversion versus conventional endarterectomy in the vascular quality initiative database. Ann Vasc Surg. 2020;65:1-9. doi: 10.1016/j.avsg.2019.07.021.
Djedovic M, Mujanovic E, Hadzimehmedagic A, Totic D, Vukas H, Vranic H. Comparison of results classical and eversion carotid endarterectomy. Med Arch. 2017;71(2):89-92. doi: 10.5455/medarh.2017.71.89-92.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Holistence Publications
This work is licensed under a Creative Commons Attribution 4.0 International License.
When the article is accepted for publication in the HSQ authors transfer all copyright in the article to the Holistence Academy Ar-Ge Yazılım Yayıncılık Eğitim Danışmanlık ve Organizasyon Ticaret Ltd. Şti.The authors reserve all proprietary right other than copyright, such as patent rights.
Everyone who is listed as an author in this article should have made a substantial, direct, intellectual contribution to the work and should take public responsibility for it.
This paper contains works that have not previously published or not under consideration for publication in other journals.
