An Official publication of The Asian Congress of Neurological Surgeons (AsianCNS)

Search Article
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Advertise Subscribe Contacts Login  Facebook Tweeter
  Users Online: 898 Home Print this page Email this page Small font sizeDefault font sizeIncrease font size  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 16  |  Issue : 2  |  Page : 321-325

Conventional carotid endarterectomy with shunt versus eversion carotid endarterectomy without shunt does the technique influence the outcome in symptomatic critical carotid stenosis


1 Department of Cardio Vascular and Thoracic Surgery, Division of Vascular Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
2 Department of General Surgery, Division of Vascular Surgery, Government Medical College, Thiruvananthapuram, Kerala, India
3 Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India

Correspondence Address:
Dr. Shivanesan Pitchai
Department of CardioVascular and Thoracic Surgery, Division of Vascular Surgery Sree Chitra Tirunal Institute for Medical Sciences and Technolog, Medical College P.O, Thiruvananthapuram - 695 011, Kerala
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ajns.AJNS_486_20

Rights and Permissions

Introduction: Carotid endarterectomy (CEA) is a surgical procedure done to prevent future embolic stroke in patients with internal carotid artery (ICA) stenosis. Conventional CEA (c-CEA) and eversion CEA (e-CEA) are two surgical techniques used for the above. As carotid shunt is rarely used in e-CEA, a certain amount of cerebral ischemia occurs in patients who were already having carotid stenosis. In this study, we have evaluated the outcome of two surgical techniques in severe carotid stenosis and impact of carotid shunting on the postoperative outcome. Materials and Methods: In this single-center prospective nonrandomized trial, a total of 62 patients who underwent CEA (c-CEA, n = 31; e-CEA, n = 31) for symptomatic ipsilateral ICA stenosis ≥50% between January 2018 and December 2019 were included. Results: A total of 62 patients who underwent CEA (c-CEA, n = 31; e-CEA, n = 31) for symptomatic ipsilateral ICA stenosis ≥50% were included in the study. There was no major stroke or stroke related death in both the study groups. One patient in e-CEA had carotid occlusion and minor stroke. There was no statistically significant difference in minor stroke (e-CEA [3.2%], c-CEA [3.2%], P = 1), transient ischemic attack (e-CEA [3.2%], c-CEA n = 0, P = 0.3), postoperative MI (e-CEA (3.2%), c-CEA (3.2%), P = 1), hematoma (e-CEA [3.2%], c-CEA n = 0, P = 0.3), and re-exploration (e-CEA [3.2%], c-CEA n = 0, P = 0.3). The incidence of cranial nerve (CN) dysfunction was significantly higher in eversion group as compared to c-CEA (e-CEA n = 6 [19.4%], c-CEA n = 1, [3.2%] P = 0.045). Conclusion: Our study showed that the early outcomes of both c-CEA and e-CEA techniques are comparable. The routine insertion of carotid shunt even though decreases the cerebral ischemic time, it does not offer any additional advantage of decreasing perioperative stroke. The choice of the CEA technique depends on the experience and familiarity of the individual surgeon as both the techniques have their own advantages and disadvantages.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed77    
    Printed0    
    Emailed0    
    PDF Downloaded15    
    Comments [Add]    

Recommend this journal