Eversion versus conventional carotid endarterectomy: a prospective study.

P Cao; G Giordano; P De Rango; S Caporali; M Lenti; S Ricci; L Moggi

doi:10.1016/s1078-5884(97)80204-3

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Eversion versus conventional carotid endarterectomy: a prospective study.

P Cao·G Giordano·P De Rango·S Caporali·M Lenti·S Ricci·L Moggi

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Abstract

OBJECTIVES: To analyse comparatively eversion and conventional CEA for later association with restenosis, perioperative stroke/death and ipsilateral cerebrovascular events (early, late, disabling and non-disabling). DESIGN: Prospective non-randomised clinical study. MATERIALS AND METHODS: A total of 469 patients underwent 514 procedures; 274 (53%) eversion CEA and 240 (47%) conventional CEA. Perioperative monitoring was carried out by clinical evaluation under local anaesthesia or by transcranial Doppler under general anaesthesia. Follow-up was carried out by clinical evaluation and Duplex scanning. RESULTS: Clamping time was significantly shorter in the eversion group (25.5 +/- 7.4 vs. 28.3 +/- 10.1 min; p = 0.0001; CI delta 4.40/1.12). The perioperative disabling stroke/death rate was 0.7% for eversion vs. 1.2% for conventional CEA, p = 0.6; odds ratio (OR), 0.58. There were two early carotid occlusions (within 30 days) in both groups. According to life-table analysis, after 3 years the probability of > 50% carotid restenosis was significantly lower in the eversion group (2.2% vs. 6.9%, p = 0.03; relative risk reduction 67%). There were no significant differences between the two groups relative to new cerebrovascular events (92% in both groups, p = 0.6). Using multivariate analysis (Cox regression), eversion CEA, and to a lesser extent standard CEA with patch, appeared to protect the vessel from restenosis. CONCLUSIONS: The eversion technique was associated with reduced clamping time and probability of restenosis. However, because of the nature of a non-randomised study, the present analysis should be confirmed by a multicentre randomised trial.

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Aged Carotid Artery, Common Carotid Artery, External Carotid Stenosis Endarterectomy, Carotid Female Follow-Up Studies Humans Male Middle Aged Postoperative Complications Probability Prospective Studies Recurrence Risk Factors Comparative Study Journal Article

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P Cao, G Giordano, P De Rango, S Caporali, M Lenti, S Ricci, L Moggi. 1997. Eversion versus conventional carotid endarterectomy: a prospective study.. https://doi.org/10.1016/s1078-5884(97)80204-3

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