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Clinical Trial
. 2000 Jul;232(1):119-25.
doi: 10.1097/00000658-200007000-00017.

A prospective randomized study on bilateral carotid endarterectomy: patching versus eversion

E Ballotta  1 , L Renon, G Da Giau, A Toniato, C Baracchini, E Abbruzzese, M Saladini, P Moscardo
Affiliations
Clinical Trial

A prospective randomized study on bilateral carotid endarterectomy: patching versus eversion

E Ballotta et al. Ann Surg. 2000 Jul.

Abstract

Objective: To compare the clinical outcome and restenosis incidence of patients who underwent carotid endarterectomy with patch closure (CEAP) on one side and carotid eversion endarterectomy (CEE) on the other.

Summary background data: Although a few investigators have compared the results of CEAP versus CEE, no reports have compared the outcome of CEAP versus CEE in the same patient.

Methods: Eighty-six patients were randomly selected for sequential surgical treatment involving either CEAP/CEE or CEE/CEAP. All patients underwent postoperative duplex ultrasound study and clinical follow-up at 1, 6, and 12 months and every year thereafter. Various factors were analyzed to ascertain any association with restenosis, and Kaplan-Meier analysis was used to estimate the risk of restenosis.

Results: Demographic and clinical data were similar in the CEAP and CEE groups. The selective shunting rate was statistically higher in the CEAP group. There were no perioperative deaths. Although the incidence of perioperative ipsilateral stroke was not significant, CEAP patients had a rate of combined transient ischemic attacks and strokes that approached statistical significance. The mean follow-up was 40 months. CEAP patients had a significantly higher incidence of restenosis and combined occlusive events and restenoses. Kaplan-Meier analysis showed that CEE had a significantly better cumulative patency rate than CEAP and that freedom from restenoses at 24 and 36 months was 87% and 83% for CEAP and 98% and 98% for CEE, respectively.

Conclusions: CEE is less likely to cause perioperative neurologic complications and restenoses than CEAP. The significantly higher rate of unilateral recurrence suggests that local factors play a more important role than systemic factors in the occurrence of restenosis.

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Figures

None
Figure 1. Kaplan-Meier analysis curve showing the cumulative patency rate and freedom from restenosis (>50%) or occlusive events for the two groups.
See this image and copyright information in PMC

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