Comparison of carotid endarterectomy with primary closure versus patch angioplasty

Carotid endarterectomy (CEA) is a critical intervention for carotid artery stenosis, a leading cause of stroke. This study compares two CEA techniques primary closure and patch angioplasty, evaluating their impact on short- and long-term outcomes, particularly recurrent stenosis and stroke incidence. This retrospective study evaluated 140 patients who underwent endarterectomy for severe carotid artery stenosis (> 70%). Using consecutive sampling, participants were divided into two groups based on intraoperative criteria: a primary closure group (n = 70) and a patch angioplasty group (n = 70). The surgical approach (primary/conventional) was determined intraoperatively based on vessel diameter and the surgeon’s judgment. Patients were retrospectively assessed for early and late restenosis rates (defined as > 50% lumen narrowing) using ultrasound every 6 months over a 5-year follow-up period. This study compared outcomes in 140 patients with severe carotid stenosis (> 70%) who underwent primary closure (n = 70) or patch angioplasty (n = 70) based on intraoperative anatomical criteria. The results of this study showed no statistically significant difference between the two treatment groups regarding recurrent carotid stenosis (> 50% lumen narrowing) and recurrent stroke in both short-term and long-term follow-ups. Both techniques, primary closure and patch angioplasty, were similarly effective in reducing the recurrence of stenosis and stroke. The data were analyzed using independent t-tests and Chi-square tests. The results from the statistical tests indicated that the differences observed between the groups were not statistically significant (p > 0.05). Based on the findings of this study, it can be concluded that both primary closure and patch angioplasty are acceptable methods for carotid endarterectomy. The choice of technique should be based on the patient’s clinical characteristics and the surgeon’s experience. However, further studies with larger sample sizes and longer follow-up periods are needed to obtain more definitive results.