Tünel Hüseyin Ali, Hafez İzzet, Diken Adem İlkay, Hanedan Muhammed Onur
Department of Cardiovascular Surgery, Başkent University Adana Medical and Research Center, Adana, Türkiye.
Department of Cardiovascular Surgery, Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, Trabzon, Türkiye.
Turk Gogus Kalp Damar Cerrahisi Derg. 2025 Apr 30;33(2):133-143. doi: 10.5606/tgkdc.dergisi.2025.27226. eCollection 2025 Apr.
This study aims to evaluate the mid- and long-term outcomes of patients who underwent carotid endarterectomy with double-layer primary arteriotomy closure technique.
Between January 2011 and January 2021, a total of 94 patients (58 males, 36 females; mean age: 66.5±8.5 years; range, 40 to 82 years) who underwent carotid endarterectomy were retrospectively analyzed. Doppler ultrasonography, computed tomography or magnetic resonance angiography, and digital subtraction angiography were utilized during follow-up. Stenoses of 50% and above were defined as restenosis.
The mean carotid clamp time was 11.72±2.30 and the mean follow-up was 54.18±27.71 months. Two patients (2.1%) underwent revision due to bleeding and hematoma. No new cerebrovascular events were observed in the postoperative period (<30 days). During the follow-up, six (6.4%) patients with ≥50% stenosis on the same side and 14 (14.9%) patients with stenosis on the opposite side were identified. Primary patency rates were found to be 99% at one year, 95.4% at three years, 90% at five years, 71% at seven years, and 71% at nine years. Age was the only independent risk factor affecting survival.
Our study results suggest that this technique can be used safely in patients with appropriate internal carotid artery diameter with favorable mid- and long-term patency rates.
本研究旨在评估采用双层原发性动脉切开闭合技术进行颈动脉内膜切除术患者的中长期预后。
回顾性分析2011年1月至2021年1月期间共94例行颈动脉内膜切除术的患者（58例男性，36例女性；平均年龄：66.5±8.5岁；范围40至82岁）。随访期间采用多普勒超声、计算机断层扫描或磁共振血管造影以及数字减影血管造影。50%及以上的狭窄定义为再狭窄。
平均颈动脉夹闭时间为11.72±2.30分钟，平均随访时间为54.18±27.71个月。2例患者（2.1%）因出血和血肿接受了翻修手术。术后30天内未观察到新的脑血管事件。随访期间，同侧狭窄≥50%的患者有6例（6.4%），对侧狭窄的患者有14例（14.9%）。发现1年时的原发性通畅率为99%，3年时为95.4%，5年时为90%，7年时为71%，9年时为71%。年龄是影响生存的唯一独立危险因素。
我们的研究结果表明，该技术可安全用于具有合适颈内动脉直径的患者，中长期通畅率良好。
