Long-term results conventional and eversion carotid endarterectomy

Golets KO, Gaganova TS, Kokaya RV, et al. Long-term results conventional and eversion carotid endarterectomy. S.S. Korsakov Journal of Neurology and Psychiatry. 2023;123(8‑2):70‑76. (In Russ.)
https://doi.org/10.17116/jnevro202312308270

Подписка 2026 Журнал неврологии и психиатрии им. С.С. Корсакова. Спецвыпуски (S.S. Korsakov Journal of Neurology and Psychiatry (special issues))

Использование инфографики авторами научных работ

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OBJECTIVE

To analyze immediate and long-term results of conventional and eversion carotid endarterectomy (CEA) within a multicenter registry.

MATERIAL AND METHODS

This retrospective, multi-center, comparative study included 375 patients who underwent CEA between February 1, 2018 and February 1, 2022. Depending on the type of operation, the sample was stratified into the eversion CEA (group 1, n=218) and conventional CEA with plasty of the reconstruction area with a diepoxy-treated xenopericardium patch (group 2, n=157). The long-term follow-up period was 26.5±18.3 months. Information about the condition of patients and the development of complications was obtained by telephone questioning and calling patients to the clinic for a follow-up examination.

RESULTS

No myocardial infarction was diagnosed in the hospital postoperative period. There were no statistically significant differences in the frequency of acute cerebrovascular accident. The only cause of death after conventional CEA was hemorrhagic stroke. According to the section study, the cause of death was edema with dislocation of the brain stem. The remaining strokes in both groups (1 case each) were of the ischemic type. The probable cause was a distal embolism following the use of a temporary shunt. During conservative treatment, the neurological deficit completely regressed on days 21 and 26, respectively. In the late postoperative period, significant differences were obtained in the incidence of stroke (group 1: n=2; 0.91%; group 2: n=6; 3.8%; p=0.05; OR — 0.23; 95% CI=0.04—1.17) and restenosis of the internal carotid artery (ICA) more than 60% (group 1: n=0; group 2: n=11; 7.0%; p<0.0001; OR — 0.03, 95% CI=0.001—0.49).

CONCLUSION

The eversion CEA technique demonstrated a lower risk of developing hemodynamically significant restenosis of the internal carotid artery in the long-term follow-up period. To obtain convincing evidence of the effectiveness of eversion or conventional CEA, additional randomized multicenter trials with the inclusion of results in clinical guidelines are required.

Keywords:

carotid endarterectomy

eversion carotid endarterectomy

classic carotid endarterectomy

restenosis

patch

long-term period

Authors:

Golets K.O.

North-Western State Medical University I.I. Mechnikov

ORCID: 0000-0002-2544-7664

Gaganova T.S.

North-Western State Medical University I.I. Mechnikov

ORCID: 0000-0001-7748-6625

Kokaya R.V.

North-Western State Medical University I.I. Mechnikov

ORCID: 0000-0001-7558-9997

Golokhvastov S.V.

Kemerovo State Medical University

ORCID: 0000-0001-8242-8518

Zarkua N.E.

North-Western State Medical University I.I. Mechnikov

ORCID: 0000-0002-7457-3149

Zharova A.S.

North-Western State Medical University I.I. Mechnikov

ORCID: 0000-0001-9474-4972

Korotkikh A.V.

Regional Clinical Hospital No. 2

Kazantsev A.N.

Korolev Regional Clinical Hospital

SPIN RSCI: 8396-1845
Scopus AuthorID: 57196122083
ORCID: 0000-0002-1115-609X

Received:

18.06.2022

Accepted:

09.07.2022

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