Primary closure after a carotid endarterectomy

Surg Today. 2007;37(3):187-91. doi: 10.1007/s00595-006-3385-4. Epub 2007 Mar 9.

Abstract

Purpose: The prevalences of restenosis and stroke after a carotid endarterectomy (CEA) tend to differ substantially according to the surgeon. Primary closure after a CEA was the routine procedure in our institute. The primary objectives of this study were to compare the results of patients of a primary arteriotomy closure in CEA between our own and others' results based on the findings in the literature.

Methods: One hundred and sixty-six patients who underwent a primary closure were analyzed. Perioperative neurologic deficits were determined by the neurologist. Restenosis was defined as >50% stenosis on duplex scan. The range of follow-up was 7-112 months.

Results: Stroke including transient ischemic attack occurred within 30 postoperative days in 3 patients and after 30 postoperative days in 1 of the 166 patients. Five patients showed >50% asymptomatic restenosis. Two patients were treated with stent insertion and one underwent reoperation. One patient showed total occlusion during the follow-up period without any neurological deficits. One patient showed 50%-70% stenosis, and no intervention was done.

Conclusions: The rates of recurrent stenosis and postoperative stroke were found to be sufficiently low following a primary closure to justify the continued use of this technique.

MeSH terms

  • Aged
  • Carotid Stenosis / etiology
  • Carotid Stenosis / surgery*
  • Endarterectomy, Carotid / adverse effects
  • Endarterectomy, Carotid / methods*
  • Female
  • Humans
  • Ischemic Attack, Transient / etiology
  • Male
  • Middle Aged
  • Recurrence
  • Stroke / etiology