Comparison of carotid endarterectomy using primary closure, patch closure, and eversion techniques

Background: This study was undertaken to evaluate the role of eversion endarterectomy in the management of extracranial carotid occlusive disease. Methods: A retrospective review was performed of all patients undergoing carotid endarterectomy between July 1994 and July 1998. After reviewing the records, patients were assigned to one of three groups: eversion (ECEA); open with primary closure (CEA°); or open with patch closure (CEAP). Statistical comparisons were made. Results: The 190 index cases comprised 33 ECEA (17%), 15 CEA° (8%), and 142 CEAP (75%). Both ECEA and CEA° were more likely to be done on males versus females compared with CEAP (P = 0.01). For the entire 190 cases, stroke occurred in 1 patient (0.5%); and myocardial infarction in 2 patients (1%), resulting in death in both. Two patients (1.4%) in the CEAP group have undergone redo surgery at 8 and 24 months. Conclusions: This study demonstrates that eversion endarterectomy achieves early results similar to open endarterectomy with and without patch closure.