ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Early and Mid-Term Results of Carotid Endarterectomy With Anterior Transverse Arteriotomy
Bayer Çınar, Onur Göksel, Hakkı Aydoğan, Uğur Filizcan, Şebnem Çetemen, Ergin Eren
Dr. Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Merkezi, Kalp ve Damar Cerrahisi Kliniği, İstanbul
Background: Stroke is the second most common cardiovascular, and the leading cause of neurological mortality. Changes in the techniques of carotid endarterectomy (CEA) have considerable influence on the immediate and mid-term results and on the need for reinterventions. This study was designed to evaluate the immediate and mid-term results of anterior transverse arteriotomy in CEA operations.

Methods: This retrospective study included 95 patients (22 females, 73 males; mean age 67.5 years; range 48 to 78 years) who underwent CEA with a transverse arteriotomy. The preoperative findings and perioperative events and the results of control examinations in the first week, and first, sixth, and 12th months were recorded. The patients were examined by Doppler ultrasonography for residual stenosis, restenosis, occlusion, and pseudoaneurysm in the sixth and 12th months. The mean follow-up period was 16.4 months (range 12-38 months).

Results: Transient ischemic attacks and unilateral carotid stenoses of more than 70% were the most common presentations. Twenty-seven patients (28.4%) had coronary artery disease and 17 patients (17.9%) had peripheral arterial obstructive disease. Shunting was used in four patients (4.2%). The mean clamping time was 8.9±1.9 minutes. Perioperatively, two patients developed hemiparesis and facial paresis, respectively. Mortality did not occur. Within the follow-up period, none of the patients had neurologic events, residual stenosis, restenosis, occlusion, or pseudoaneurysm.

Conclusion: Carotid endarterectomy with anterior transverse arteriotomy under local anesthesia is an easy, effective, and quick technique. It provides an adequate surgical exposure and yields acceptable immediate and mid-term results. Avoidance of patch-closure techniques particularly in thin arteries is an important advantage.

Keywords : Carotid stenosis/surgery; endarterectomy, carotid/ methods; suture techniques; ultrasonography, Doppler
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