OBJECTIVE

To analyze in-hospital and long-term results of conventional and eversion carotid endarterectomy (CEE).

MATERIAL AND METHODS

There were 1493 conventional CEEs with patch repair (group 1) for the period from January 2015 to December 2019. Group 2 comprised 637 eversion CEEs. In-hospital follow-up period was 6 days, long-term follow-up — 48.8±19.6 months. Incidence of complications including mortality, myocardial infarction (MI), stroke/transient ischemic attack (TIA), thrombosis/restenosis within the reconstruction zone and combined endpoint (death + stroke/TIA + MI) was evaluated.

RESULTS

There were no significant in-hospital differences in postoperative morbidity. Overall incidence of cardiovascular events after conventional CEE was 1.1% (n=17), after eversion CEE — 1.1% (n=7) (p=0.88). In long-term period, both groups were comparable regarding mortality (6.7% (n=101) vs. 6.9% (n=44), p=0.97), incidence of MI (5.5% (n=83) vs. 4.8% (n=31), p=0.58), stroke/TIA (5% (n=75) vs. 4.5% (n=29), p=0.72). Thrombosis/occlusion within the reconstruction zone (5.2% (n=79) vs. 5.3% (n=18), p=0.01) and significant restenosis (4.2% (n=64) vs. 2.1% (n=14), p=0.02) were more common after conventional CEE.

CONCLUSION

Conventional CEE with patch repair and eversion CEE ensure similar prevention of adverse cardiovascular events throughout in-hospital and long-term follow-up period. However, patch repair is characterized by higher incidence of thrombosis/restenosis/occlusion that makes eversion technique more preferable.