TITLE

Comparison of Standard Carotid Endarterectomy with Dacron Patch Angioplasty versus Eversion Carotid Endarterectomy During a 4-Year Period

AUTHOR(S)
Littooy, Fred N.; Gagovic, Veronika; Sandu, Cezar; Mansour, Ashraf; Kang, Steven; Greisler, Howard P.
PUB. DATE
February 2004
SOURCE
American Surgeon;Feb2004, Vol. 70 Issue 2, p181
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Currently, the two primary approaches to carotid endarterectomy for extracranial carotid stenosis are carotid endarterectomy with patch angioplasty and eversion carotid endarterectomy. In a retrospective study over a 4-year period from 1998 to 2002, we had an opportunity to compare the two approaches as two surgeons utilized carotid endarterectomy with Dacron patch angioplasty and two other surgeons utilized eversion carotid endarterectomy. During the 4-year period, 189 carotid endarterectomies were performed, 125 with Dacron patch angioplasty (CE-P) and 64 with eversion (EE) endarterectomy. There were no significant differences in age of the patients, operative indication, or associated risk factors between the two groups. Perioperative outcome measurement in the CE-P versus EE included stroke or transient ischemic attack, 1.6 per cent versus 1.56 per cent, cranial nerve injury, 2.4 per cent versus 3.13 per cent; death, 0.8 per cent versus 0 per cent; need for operative conversion or revision, 2.4 per cent versus 7.81 per cent, respectively. Only the need for operative conversion or revision reached significant difference (P < 0.05), although the need decreased to 4 per cent for the last 50 EE cases. Recurrent stenosis of 50 per cent to 79 per cent was 4.88 per cent versus 3.13 per cent and >80 per cent was 0.81 per cent versus 0 per cent in the CE-P versus EE group over a follow up of 16.3 months and 17.0 months, respectively. We conclude that both CE-P and EE are equally efficacious operative approaches to extracranial carotid occlusive disease.
ACCESSION #
12619009

 

Related Articles

  • Expert Commentary. Matsumura, Jon S. // Perspectives in Vascular Surgery & Endovascular Therapy;Apr2004, Vol. 16 Issue 2, p120 

    The article discusses the status of carotid angioplasty and stenting and the evolution of endovascular procedure in patients with carotid diseases. Carotid artery stenting is in its infancy and the devices for this procedure, including distal protection devices, are in an early stage of...

  • Hospital and surgeon determinants of cartoid endarterectomy outcomes.  // Current Medical Literature: Stroke Review;2003, Vol. 7 Issue 2, p58 

    Studies hospital and surgeon determinants of carotid endarterectomy outcomes. Effects of skills of surgeons on the surgical treatment of carotid stenosis; Inverse relationship between hospital and surgeon case volumes and adverse outcomes.

  • Is the Retrojugular Approach Safer Than the Conventional Approach for Carotid Endarterectomy? Kluk, J.; Grainger, S.; Nyamekye, I. K. // World Journal of Surgery;Jul2009, Vol. 33 Issue 7, p1533 

    The retrojugular approach is promoted as an alternative to traditional antejugular carotid endarterectomy. Absence of named posterior venous branches and ease of distal internal carotid dissection reduce time for carotid exposure together with improved distal exposure. However, a higher...

  • Review: Endovascular treatment and carotid endarterectomy do not differ for carotid stenosis. Brass, Lawrence M. // ACP Journal Club;Sep/Oct2005, Vol. 143 Issue 2, p35 

    The article presents an answer to a clinical question related to the risks and benefits of endovascular treatment compared with carotid endarterectomy in patients with carotid stenosis. Quality of individual studies was assessed for method of randomization, allocation concealment,...

  • High-grade symptomatic and asymptomatic carotid stenosis in the very elderly. A challenge for proponents of carotid angioplasty and stenting. Ballotta, Enzo; Da Giau, Giuseppe; Militello, Carmelo; Barbon, Bruno; De Rossi, Aldo; Meneghetti, Giorgio; Baracchini, Claudio // BMC Cardiovascular Disorders;2006, Vol. 6, p12 

    Background: Carotid angioplasty and stenting (CAS) is often considered as the preferred treatment for severe carotid occlusive disease in patients labelled as "high risk", including those aged 80 or more. We analyzed 30-day stroke risk and death rates after carotid endarterectomy (CEA) for...

  • Technology.  // H&HN: Hospitals & Health Networks;10/20/93, Vol. 67 Issue 20, p31 

    Reports on two studies on atherectomy and balloon angioplasty published in the `New England Journal of Medicine'. Equal effectiveness in unclogging heart vessels; Comparison of costs; Complications for atherectomy patients.

  • Decreased Recurrent Carotid Stenosis by Routine Patching and Intraoperative Scanning. Mansour, M. Ashraf; Webb, K. Michael; Kang, Steven S.; Morasch, Mark D.; Littooy, Fred N.; Labropoulos, Nicos; Baker, William H. // American Surgeon;Apr2001, Vol. 67 Issue 4, p328 

    Our objective was to review the results of carotid endarterectomies (CEAs) with Dacron patch angioplasty and intraoperative color-flow duplex scanning (CFS). In a 3-year period, patients who underwent CEA with Dacron patch angioplasty and intraoperative CFS were studied. We excluded patients who...

  • Endarterectomy vs. Angioplasty in Patients with Symptomatic Severe Carotid Stenosis (EVA-3S) Trial.  // Cerebrovascular Diseases;2004, Vol. 18 Issue 1, p62 

    Endarterectomy versus Angioplasty in Patients with Symptomatic Severe Carotid Stenosis (EVA-3S) is a French multicenter, non-inferiority randomized trial with national research organisation funding. In brief, patients are eligible if they have experienced a carotid TIA or non-disabling stroke...

  • A Review on the Comparison of Different Treatments for Carotid In-Stent Restenosis. He, Chizhong; Wang, Shuo; Zhou, Xiaohong; Yang, Zhexian // Canadian Journal of Neurological Sciences;Nov2019, Vol. 46 Issue 6, p666 

    Different treatment options for carotid in-stent restenosis (ISR) have been reported with good outcome, including carotid endarterectomy (CEA), repeated carotid angioplasty stenting (CAS) and percutaneous transluminal angioplasty (PTA) with drug-coated balloons (DCBs). However, the optimal...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics