Does surgical technique influence the postoperative hemodynamic disturbances and neurological outcomes in carotid endarterectomy?

Deser S. B., Demirağ M. K., Kolbakır F.

ACTA CHIRURGICA BELGICA, vol.119, no.2, pp.78-82, 2019 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 119 Issue: 2
  • Publication Date: 2019
  • Doi Number: 10.1080/00015458.2018.1459364
  • Journal Name: ACTA CHIRURGICA BELGICA
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.78-82
  • Keywords: Carotid artery endarterectomy, eversion technique, conventional technique, stroke, hypertension, BARORECEPTOR SENSITIVITY, EVERSION, DISEASE, MANAGEMENT
  • Ondokuz Mayıs University Affiliated: Yes

Abstract

Introduction: The carotid endarterectomy is already well established in patients with symptomatic or asymptomatic internal carotid artery (ICA) stenosis. The aim of this study was to determine whether there is a difference in postoperative blood pressure changes, stroke rate and postoperative complications following eversion carotid endarterectomy (E-CEA) and conventional carotid endarterectomy (C-CEA). Methods: From 1 January 2010 to 31 March 2017 consecutive patients admitted to our department with symptomatic or asymptomatic ICA stenosis were included in this retrospective study. During the 7-year period, 175 CEAs were performed in 166 consecutive patients (25 females, 141 males; mean age 70.6 +/- 14.4 years; range 47 to 92 years). Results: The mean operative and cross-clamping time were shorter for E-CEA (72 +/- 14.3 minutes vs. 115 +/- 17.4 minutes, p < .001), (22 +/- 7.7 vs 34 +/- 6.3, p < .001) respectively. No significant difference was noted between the groups for the occurrence of perioperative stroke (p = .501). No significant difference was noted for postoperative blood pressure difference on the 6th hour and the 24th hour after surgery between E-CEA and C-CEA (p = .130). Conclusions: E-CEA was associated with significant reduction in operative time and cross-clamping time however, increases postoperative bleeding. No difference was noted for postoperative stroke and blood pressure distortion between E-CEA and C-CEA.