Eversion Carotid Endarterectomy : A Short Review

Davidović, Lazar; Tomić, Ivan

doi:10.3340/jkns.2019.0201

Cited by 8 publications

(6 citation statements)

References 23 publications

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“…If it is performed by an experienced surgeon, it is safe. 1,12,27) According to the present study, a preoperative color Doppler ultrasound image is a reliable preoperative estimator of the peripheral extension of the atherosclerotic plaque in the ICA.…”

Section: Discussionmentioning

confidence: 72%

Doppler is a Safe Criterion for Ensuring the Implementation of Eversion Carotid Endarterectomy

Christoforou

Bakoyiannis

Konidari

et al. 2021

Annals of Vascular Diseases

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Objective: This is a prospective study concerning patients with symptomatic or asymptomatic significant carotid stenosis. Preoperative and intraoperative measurements of the peripheral extension of the carotid atherosclerotic plaque have been compared with postoperative measurements to identify a preoperative method that safely allows the performance of eversion carotid endarterectomy (ECEA). Materials and Methods: The study included 37 patients with symptomatic internal carotid stenosis greater than 70% and 43 patients with asymptomatic stenosis greater than 80%. Four methods were used for establishing criteria: preoperative Doppler examination, intraoperative measurement of the carotid atheroma before artery division, measurement of the removed plaque, and histological measurement of the plaque. Results: Preoperative Doppler examination is a method of estimating the actual distal extension of the internal carotid artery (ICA) atheroma, with correction as dictated by the following formula: In all cases, preoperative ultrasound measurements and intraoperative estimation confirmed the correct decision to proceed with the eversion technique. Conclusion: The peripheral extension of the atherosclerotic plaque of the ICA can be assessed with accuracy by preoperative Doppler study, which can be used with safety as a predicting criterion of the existence of healthy peripheral carotid tissue that allows the performance of the eversion endarterectomy technique.

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Section: Discussionmentioning

confidence: 72%

Doppler is a Safe Criterion for Ensuring the Implementation of Eversion Carotid Endarterectomy

Christoforou

Bakoyiannis

Konidari

et al. 2021

Annals of Vascular Diseases

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“…In this case, an eversion carotid endarterectomy was performed. This is known not only as the main procedure in carotid surgery, but also it is the most frequent vascular procedure [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…The advantages of this method include no need for patch closure and the overall carotid clamping time being shorter, therefore, the total ischemic and operative time is also shorter. Due to the oblique shape of anastomosis, eversion carotid endarterectomy is associated with a low risk of long-term restenosis [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Revascularization in a Patient with Atypical Manifestations of Hypoperfusion

2022

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Background and Objectives: Carotid revascularization is one of the most effective treatment options in patients with severe carotid artery stenosis causing hypoperfusion in basal ganglia. Atypical manifestations include hyperkinetic movements, noted as extremely rare. We report a case about a patient with 2-months-long complaints of Uncontrollable movements in his right side of the body subsided after carotid revascularization. Case presentation: A 71-year-old male was admitted to Pauls Stradins Clinical University Hospital with the main complaints of 2-months-long uncontrollable movements in his right hand and his right leg. When performing coordination tasks, slight inaccuracy was noted with the right-side extremities. Hyperkinetic movements—choreoathetosis in the right side of the patient’s face, arm, and leg—were seen. Computed tomography angiography revealed subocclusion in the proximal segment of the left internal carotid artery and 30% stenosis in the proximal segment of the right internal carotid artery. The patient was consulted by a vascular surgeon. Eversion endarterectomy of the left internal carotid artery was performed. The early postoperative period occurred without complications. The patient was discharged from the hospital 2 days after the surgery in good overall health condition. Two months later, choreoathetotic movements in his right side of the body had markedly decreased. No focal neurologic deficits were noted. Conclusions: Revascularization may be effective by eliminating emboli and stenosis, leading to hypoperfusion in watershed territories. A case of a 71-year-old male patient with the main complaints of 2-months-long uncontrollable movements in his right side of the body subsiding after carotid revascularization was demonstrated. It is vital to recognize atypical manifestations of hypoperfusion, associated with stenosis in internal carotid arteries, to early make a diagnosis, to perform an appropriate treatment, and to reduce the risk of cerebral infarction in the future, resulting in a longer high-quality life for the patient.

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“…Studies showed that both eversion CEA and CCEA operations were safety methods with very rates low complication. Therefore, it is important that carotid surgery is performed by experienced surgeons with sufficient experience of the procedure, as emphasized in the guidelines (8,9).…”

Section: Discussionmentioning

confidence: 99%

Carotid endarterectomy; A new center, two years results

Arslan¹,

Fedakar²

2022

AZJCVS

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Aim: We aimed to evaluate the demographic characteristics and early postoperative complications of patients who underwent conventional carotid endarterectomy (CEA) in a secondary level hospital retrospectively. Material and Methods: Forty-six patients who operated by a single surgeon at Sinop Ataturk State Hospital between January 2015 to December 2016 were included in the current study. Data regarding to demographic characteristics, symptoms, distribution of lesions, diagnostic methods, operation technique and early complications have been collected from handwritten and electronic clinical records. Results: The mean age was found as 70.9±9.7. Thirty patients were male. The most common risk factors were hypertension (93.5%), hyperlipidemia (50%), cigarette (41.3%) and diabetes (34.8%). Conventional CEA (CCEA) was performed to all patients. Patch plasty was applied to only one patient. According to the internal carotid artery stump pressure, T shunt was performed to 17.4% of patients. One patient died in early postoperative period because of myocardial infarction. In four patients; transient dysphagia, in three patients; hematoma requiring revision, in one patient; uncontrolled hypertension, and in one patients wound infection occurred. Furthermore, delirium occurred in one patient. Conclusion: Our experience CEA are compatible with the literature. Our results have supported that CCEA with measurement of carotid arter stump pressure are reliable surgical procedure for patients with carotid artery stenosis. Cardiac complications are rare but it can be mortal. Minor surgical complications are more common than death and stroke risk. However, close follow-up can prevent serious complications.

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Eversion Carotid Endarterectomy : A Short Review

Cited by 8 publications

References 23 publications

Doppler is a Safe Criterion for Ensuring the Implementation of Eversion Carotid Endarterectomy

Doppler is a Safe Criterion for Ensuring the Implementation of Eversion Carotid Endarterectomy

The Impact of Revascularization in a Patient with Atypical Manifestations of Hypoperfusion

Carotid endarterectomy; A new center, two years results

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