Abstract

BACKGROUND: The aim of this study was to compare early and long-term results of eversion carotid endarterectomy (e-CEA) and patch carotid endarterectomy (p-CEA).

MATERIAL AND METHODS: In a retrospective study, we collected data on 441 patients who underwent CEA (e-CEA=211 vs. p-CEA=230) between October 2009 and October 2015 at our institute. Economic costs, postoperative hospital days, use of shunts and antibiotics, early (30-day) complications, long-term restenosis, and mortality rates were compared between groups during 4 to 76 months of follow-up.

RESULTS: Patients in the p-CEA group had a significantly higher percentage of antibiotic use (58.3% vs. 27%, respectively; P<.0001) and shunt use (86.6% vs. 16.1%, respectively; P<.0001), longer postoperative hospital stay (7.23±0.25 days vs. 6.38±0.20 days, respectively; P<.009) and a higher medical cost (24110±1058 ¥ vs. 17257±747.6 ¥, respectively; P<.0001). The perioperative complications including stroke or transient ischemic attack, cranial nerve injury, and infection/bleeding showed no difference between the 2 groups (all P>0.05). Long-term complication, including stroke or heart attack, recurrent stenosis rate, and mortality rate, showed no difference between the 2 groups (all P>0.05). Kaplan-Meier analysis shows that the recurrent stenosis-free and survival rates were not significantly different between the 2 groups (P=0.867, P=0.177, respectively).

CONCLUSIONS: The adverse event rates of perioperative and long-term follow-up showed no significant difference between the e-CEA and p-CEA groups. Both e-CEA and p-CEA are effective for carotid artery stenosis.

Keywords: carotid stenosis, Cost-Benefit Analysis, Endarterectomy, Carotid