Key result
Eversion carotid endarterectomy demonstrates superior long-term outcomes compared to classic endarterectomy and is the preferred method when anatomical conditions permit.
Why the study?
Three main methods are used to restore patency in carotid artery bifurcation stenosis, motivating a comparative analysis of their immediate and long-term results.
Does eversion carotid endarterectomy improve immediate and long-term outcomes compared to classic carotid endarterectomy or prosthetic repair in patients with carotid artery stenosis?
Does eversion carotid endarterectomy improve immediate and long-term outcomes compared to classic carotid endarterectomy or prosthetic repair in patients with carotid artery stenosis?
Eversion carotid endarterectomy is the preferred method for carotid bifurcation reconstruction due to better long-term outcomes, provided anatomical conditions allow its use.
Immediate carotid reconstruction results are hypothesis-generating; randomized trials needed to guide technique selection.
INTRODUCTION: Nowadays, to restore the patency of the carotid artery bifurcation in atherosclerotic stenoses, three main methods of reconstruction are used, namely, classic carotid endarterectomy (cCEAE), prosthetic repair of the internal carotid artery, and eversion carotid endarterectomy (eCEAE). The study conducted a comparative analysis of the immediate and long-term results of using these methods in the case of stenosis of the carotid artery bifurcation. CONCLUSION: As regards the immediate results, the analysis of literature does not permit allow making an unambiguous conclusion about the evident advantages of a particular method of intervention. Thus, several authors obtained better results with the use of eCEAE, whereas others did not find any significant differences between eCEAE and cCEAE, if it was not a question about using a straight seam, and this can be referred to both meta-analyses and original studies. Regarding the long-term results, practically all literary sources indicate more optimal results with the use of the eversion technique. The results of the analysis imply the preference for eCEAE if the character of the lesion of the carotid bifurcation and anatomical interrelations in the surgical wound allow it.
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Dmitry F. Beloyartsev (2022) conducted a review in Atherosclerotic stenosis of the carotid artery bifurcation. Eversion carotid endarterectomy vs. Classic carotid endarterectomy and prosthetic repair was evaluated. Eversion carotid endarterectomy demonstrates superior long-term outcomes compared to classic endarterectomy and is the preferred method when anatomical conditions permit.
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