[Efficacy analysis of two surgical procedures of carotid endarterectomy in the treatment of carotid artery stenosis].

Objective: To analyze the efficacy and safety of eversion carotid endarterectomy (eCEA) and carotid endarterectomy with patch angioplasty (pCEA) in the treatment of carotid artery stenosis.

Methods: The clinical data were collected and analyzed for the patients with carotid artery stenosis undergoing carotid endarterectomy at Department of Vascular Surgery, Peking Union Medical College Hospital from October 2009 to October 2012. According to two different surgical procedures, they were divided into 2 groups of eCEA and pCEA.

Results: A total of 248 patients received a follow-up. Among 274 cases of endarterectomy, 101 cases of eCEA and 173 cases of pCEA were performed. No significant difference (P > 0.05) existed between two groups in gender, age, risk factors, stenotic degree of carotid artery or ratio of bilateral lesions. The ratio of shunt (15.8%) and antibiotics (26.7%) application, the duration of operation (88 ± 20) min, intraoperative blood loss (45 ± 16) ml and the length of stay (16 ± 4) days in the group eCEA were significantly lower than those of group pCEA (P < 0.05). There was no significant difference (P > 0.05) between two groups in the ratio of complications, surgery-related mortality, restenosis and ipsilateral stroke.

Conclusion: Both surgical procedures are both safe and effective in the treatment of carotid artery stenosis. However eCEA offers potential advantages. The choice of a particular surgical procedure depends on the surgeon experience and specific circumstances of carotid artery lesions.