Carotid Artery Eversion Endarterectomy Versus Open Thromboendarterectomy and Patch Plasty

Kakha Kuntelia,* Dieter Raithel**

Objective: For last years we changed gradually our treatment for stenosis of the internal carotid artery (ICA) from open thromboendarterectomy and Dacron-patch plasty (TEA) to eversion endarterectomy (EEA). Design: retrospective study. Methods: We have selected 250 patients operated by EEA technique and 250 TEA techniques, between January 1996 and December 1998. These results were compared. Results: clamping and operation time were significantly shorter for EEA. Neurological complications included transient ischemic 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 2,4% after EEA and 10,5% after TEA. Conclusions: EEA of the ICA is safe procedure for carotid artery reconstruction with the additional advantages of short clamping time, possibility of the simultaneous shortening of an elongated internal carotid artery, no requirement for patch plasty and the lower risk of restenosis.

Keywords:  internal carotid artery, eversion endarterectomy, patch lasty, stenosis