e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Evaluation of mid- and long-term outcomes following carotid endarterectomy with a double-layer primary arteriotomy closure technique
Hüseyin Ali Tünel1, İzzet Hafez1, Adem İlkay Diken1, Muhammed Onur Hanedan2
1Department of Cardiovascular Surgery, Başkent University Adana Medical and Research Center, Adana, Türkiye
2Department of Cardiovascular Surgery, Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, Trabzon, Türkiye
DOI : 10.5606/tgkdc.dergisi.2025.27226
Background: This study aims to evaluate the mid- and long-term outcomes of patients who underwent carotid endarterectomy with double-layer primary arteriotomy closure technique.

Methods: Between January 2011 and January 2021, a total of 94 patients (58 males, 36 females; mean age: 66.5±8.5 years; range, 40 to 82 years) who underwent carotid endarterectomy were retrospectively analyzed. Doppler ultrasonography, computed tomography or magnetic resonance angiography, and digital subtraction angiography were utilized during follow-up. Stenoses of 50% and above were defined as restenosis.

Results: The mean carotid clamp time was 11.72±2.30 and the mean follow-up was 54.18±27.71 months. Two patients (2.1%) underwent revision due to bleeding and hematoma. No new cerebrovascular events were observed in the postoperative period (<30 days). During the follow-up, six (6.4%) patients with ?50% stenosis on the same side and 14 (14.9%) patients with stenosis on the opposite side were identified. Primary patency rates were found to be 99% at one year, 95.4% at three years, 90% at five years, 71% at seven years, and 71% at nine years. Age was the only independent risk factor affecting survival.

Conclusion: Our study results suggest that this technique can be used safely in patients with appropriate internal carotid artery diameter with favorable mid- and long-term patency rates.

Keywords : Carotid endarterectomy, patch closure, primary closure
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