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A comparison of modified eversion endarterectomy versus classical endarterectomy in the surgical treatment of carotid artery stenosis

Mahmut Kış, Mahir Merdanoğlu, Mehmet Balkanay

Department of Cardiovascular Surgery, Kartal Koşuyolu Yüksek Ihtisas Training and Research Hospital, Istanbul, Turkey

Keywords: Carotid artery stenosis, endarterectomy, modified eversion technique

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Objectives: In this study, we aimed to compare the modified eversion method versus classical carotid endarterectomy in the treatment of carotid artery stenosis.

Patients and methods: A total of 112 patients (85 males, 27 females; mean age 64.8±9.5 years; range, 40 to 82 years) who underwent carotid endarterectomy in our hospital between January 2009 and December 2011 were retrospectively analyzed. The patients were divided into two groups according to the method used as the modified eversion group (n=27) and classical endarterectomy group (n=85). Doppler ultrasound of 62 patients who could be reached among these patients were evaluated and compared in terms of early results of restenosis.

Results: There was no statistically significant difference between the two groups in terms of intraoperative morbidity, mortality, and complications. While there was no mortality in the modified eversion technique, postoperative subcutaneous hematoma occurred in one (3.7%) patient and revision was applied, and morbidity in the form of right hemiplegia was observed in another patient (3.7%). In classical endarterectomy, mortality was observed in four (4.7%) patients. One (1.2%) patient underwent subcutaneous hemorrhage revision, and morbidity in the form of right hemiplegia was observed in another patient (1.2%). There was no statistically significant difference between the two groups in terms of early results of restenosis. Severe stenosis was found in the arteries undergoing endarterectomy in one patient (4.8% vs. 2.4%) in each group.

Conclusion: The modified eversion method used in our clinic is as effective as classical carotid endarterectomy. This method should be considered an alternative to the classical endarterectomy technique.

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