Eversion endarterectomy versus open thromboendarterectomy and patch plasty for the treatment of internal carotid artery stenosis.

OBJECTIVE

in 1996 we changed our treatment for stenosis of the internal carotid artery (ICA) from open thromboendarterectomy and PTFE-patch plasty (TEA) to eversion endarterectomy (EEA).

DESIGN

retrospective study.

METHODS

a total of 475 EEAs of the ICA were performed between 2/96 and 11/96. These results were compared to the results of TEA carried out between 2/94 and 11/94 (n=388).

RESULTS

clamping and operation time were significantly shorter for EEA. Neurological complications included transient ischaemic attacks in 1. 0% in the EEA group versus 1.3% after TEA (p=0.72), minor strokes (0. 6% vs. 1.8%, p=0.10) and major strokes in 1.5% versus 1.1% (p=0.59). The rate of restenosis >50% was 2.5% after EEA and 10.2% after TEA. The only detectable difference of statistical significance in complication rates was in the lesions of the hypoglossal nerve (5.3% vs. 2.6%, p=0.04).

CONCLUSIONS

EEA of the ICA is a safe procedure for carotid reconstruction with the additional advantages of short clamping time, possibility of simultaneous shortening of an elongated ICA, and no requirement for patching.