Does Surgical Technique Influence the Postoperative Hemodynamic Disturbances and Neurological Outcomes in Carotid Endarterectomy

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. © 2018, © 2018 The Royal Belgian Society for Surgery.