Document Detail


Single-center prospective, randomized analysis of conventional and eversion carotid endarterectomy.
MedLine Citation:
PMID:  18670379     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: Several studies, comparing early and long-term results of the conventional carotid endarterectomy (CEA) and eversion carotid endarterectomy (EEA), were conducted for past 10 years. Nevertheless, it still remaining difficult to choose optimal endarterectomy technique. Choice yet mainly depends of experience of attending surgeon. The aim of this study was the comparison early and long-term results of the EEA and CEA. METHODS: Randomly, 103 patients were operated on in the eversion, and 98 patients in the conventional technique; 97 (48.3%) patients were asymptomatic and 104 (51.7%) had symptomatic lesions. All patients underwent preoperative cervical duplex scanning and neurological examination. The surgical procedure was carried out under general anesthesia. In cases with retrograde blood pressure less than 20 mmHg shunt was used; 78.6% of all CEA were finished up with ''patch'' angioplasty and 21.4% by primary suture. The primary outcomes were perioperative and late mortality, perioperative and late central neurological complications, a long-term survival rate and late restenosis incidence. RESULTS: The mean follow-up was 38 months. Mortality and long-term survival rate were similar in compared groups. The perioperative central neurological complications incidence were comparable in study groups (3.9% vs 12.1% , odds ratio 3.45, 95% confidence interval 1.1-11.1; P=0.029). The late restenosis incidence was significantly lower in eversion group (0.0% vs 6.1%). CONCLUSION: EEA has an advantage over the conventional procedure. The authors recommend CEA in cases when retrograde pressure indicated the use of the intraluminal shunting.
Authors:
D M Markovic; L B Davidovic; D D Cvetkovic; Z V Maksimovic; D Z Markovic; D B Jadranin
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Journal of cardiovascular surgery     Volume:  49     ISSN:  0021-9509     ISO Abbreviation:  J Cardiovasc Surg (Torino)     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-08-01     Completed Date:  2008-12-16     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0066127     Medline TA:  J Cardiovasc Surg (Torino)     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  619-25     Citation Subset:  IM    
Affiliation:
Clinic for Vascular Surgery, Institute for Cardiovascular Diseases, Clinical Center of Serbia, Belgrade, Serbia.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Carotid Stenosis / surgery*
Chi-Square Distribution
Endarterectomy, Carotid / methods*
Female
Humans
Male
Middle Aged
Postoperative Complications
Prospective Studies
Recurrence
Risk Factors
Survival Rate
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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