Does surgical technique influence the postoperative hemodynamic disturbances and neurological outcomes in carotid endarterectomy?

Acta Chir Belg. 2019 Apr;119(2):78-82. doi: 10.1080/00015458.2018.1459364. Epub 2018 Apr 27.

Abstract

Introduction: The carotid endarterectomy is already well established in patients with symptomatic or asymptomatic internal carotid artery (ICA) stenosis. The aim of this study was to determine whether there is a difference in postoperative blood pressure changes, stroke rate and postoperative complications following eversion carotid endarterectomy (E-CEA) and conventional carotid endarterectomy (C-CEA).

Methods: From 1 January 2010 to 31 March 2017 consecutive patients admitted to our department with symptomatic or asymptomatic ICA stenosis were included in this retrospective study. During the 7-year period, 175 CEAs were performed in 166 consecutive patients (25 females, 141 males; mean age 70.6 ± 14.4 years; range 47 to 92 years).

Results: The mean operative and cross-clamping time were shorter for E-CEA (72 ± 14.3 minutes vs. 115 ± 17.4 minutes, p < .001), (22 ± 7.7 vs 34 ± 6.3, p < .001) respectively. No significant difference was noted between the groups for the occurrence of perioperative stroke (p = .501). No significant difference was noted for postoperative blood pressure difference on the 6th hour and the 24th hour after surgery between E-CEA and C-CEA (p = .130).

Conclusions: E-CEA was associated with significant reduction in operative time and cross-clamping time however, increases postoperative bleeding. No difference was noted for postoperative stroke and blood pressure distortion between E-CEA and C-CEA.

Keywords: Carotid artery endarterectomy; eversion technique; conventional technique; stroke; hypertension.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Blood Pressure / physiology
  • Carotid Stenosis / physiopathology*
  • Carotid Stenosis / surgery*
  • Endarterectomy, Carotid / adverse effects*
  • Endarterectomy, Carotid / methods*
  • Female
  • Hemodynamics
  • Humans
  • Male
  • Middle Aged
  • Postoperative Period
  • Risk Factors
  • Stroke / etiology