Carotid Eversion Endarterectomy: Perioperative Outcome and Restenosis Incidence

Abstract

Carotid endarterectomy (CEA) for stroke prevention can be performed with minimal perioperative mortality and morbidity rates. The type of surgical technique used is important to achieve optimal outcome from CEA. The purpose of this study was to analyze the perioperative and late results of carotid eversion endarterectomy (CEE) in more than 400 procedures. From August 1992 to December 1999, 402 primary CEEs were performed in 388 selected patients for symptomatic (235/58.4%) and asymptomatic (167/41.6%) carotid lesions. During the same period, 234 primary CEAs with patch closure were performed in 229 selected patients. All CEAs were carried out with continuous electroencephalographic monitoring for selective shunting, using deep general anesthesia. All patients underwent postoperative duplex ultrasound study and clinical follow-up at 1, 6, and 12 months and every year thereafter. The mean follow-up was 50 months (range 3-88). Main end points were perioperative stroke and death, and restenosis. Our results showed that use of the CEE procedure can reduce perioperative mortality and stroke risk rates to around zero and results in no restenosis.