Eversion endarterectomy versus open thromboendarterectomy and patch plasty for the treatment of internal carotid artery stenosis.

Objective: in 1996 we changed our treatment for stenosis of the internal carotid artery (ICA) from open thromboendarterectomy and PTFE-patch plasty (TEA) to eversion endarterectomy (EEA).

Design: retrospective study.

Methods: a total of 475 EEAs of the ICA were performed between 2/96 and 11/96. These results were compared to the results of TEA carried out between 2/94 and 11/94 (n=388).

Results: clamping and operation time were significantly shorter for EEA. Neurological complications included transient ischaemic attacks in 1. 0% in the EEA group versus 1.3% after TEA (p=0.72), minor strokes (0. 6% vs. 1.8%, p=0.10) and major strokes in 1.5% versus 1.1% (p=0.59). The rate of restenosis >50% was 2.5% after EEA and 10.2% after TEA. The only detectable difference of statistical significance in complication rates was in the lesions of the hypoglossal nerve (5.3% vs. 2.6%, p=0.04).

Conclusions: EEA of the ICA is a safe procedure for carotid reconstruction with the additional advantages of short clamping time, possibility of simultaneous shortening of an elongated ICA, and no requirement for patching.