Comparison of patch carotid endarterectomy and eversion carotid endarterectomy: a retrospective study of long-term follow-up

doi:10.11817/j.issn.1673-9248.2023.04.006

Abstract

Abstract:

Objective

To compare long-term outcomes of patch carotid endarterectomy (p-CEA) and eversion carotid endarterectomy (e-CEA).

Methods

In a retrospective study, data on 340 patients (372 operations, p-CEA=193, e-CEA=179) who underwent carotid endarterectomy were collected between October 2009 and October 2015 in the Vascular Surgery Department of Peking Union Medical College Hospital. The long-term incidence of all-cause death, myocardial infarction, stroke, ipsilateral stroke, and recurrence of symptoms were compared between two groups during follow-up.

Results

The comparison of baseline results showed that the proportion of patients with hyperlipidemia in the p-CEA group was higher than that in the e-CEA group (46.1% vs 34.6%, P=0.032). During a maximum follow-up period of 133 months, there was no statistical difference between the p-CEA group and the e-CEA group in mortality (17.8% vs 13.8%, P=0.4855), myocardial infarction (7.8% vs 5.9%, P=0.360), stroke (12.8% vs 15.6%, P=0.228), ipsilateral stroke (4.3% vs 5.9%, P=0.282), and recurrence of symptoms (χ²=0.198, df=15.622, P=0.85).Kaplan-Meier analysis showed that there was no significant difference in postoperative restenosis and postoperative death at year 6 between e-CEA and p-CEA groups (P=0.87; P=0.18), and postoperative death and stroke at year 8 between e-CEA and p-CEA groups (P=0.34; P=0.24).

Conclusion

The adverse event rates in 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.

Key words: Carotid endarterectomy, patch, eversion, Carotid artery stenosis, Long-term death

Yang Yang, Sheng Yan, Zuoguan Chen, Zhiyuan Wu, Yongpeng Diao, Qing Gao, Yuexin Chen, Yuehong Zheng, Yongjun Li. Comparison of patch carotid endarterectomy and eversion carotid endarterectomy: a retrospective study of long-term follow-up[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2023, 17(04): 337-343.

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URL: https://zhnxgbzz.cma-cmc.com.cn/EN/10.11817/j.issn.1673-9248.2023.04.006

https://zhnxgbzz.cma-cmc.com.cn/EN/Y2023/V17/I04/337

Figures/Tables 5

一般资料	所有患者（372例次）	p-CEA组（193例次）	e-CEA组（179例次）	统计值	P值
年龄（岁， $x ¯$ ±s）	66.48±8.30	66.78±8.80	66.16±7.75	t=0.723	0.470
男性[例（%）]	301（80.9）	156（80.8）	145（81.0）	χ²=0.000	1.000
危险因素[例（%）]
高血压	259（69.6）	134（69.4）	125（69.8）	χ²=0.000	1.000
糖尿病	89（23.9）	43（22.3）	46（25.7）	χ²=0.423	0.515
冠心病	140（37.6）	80（41.5）	60（33.5）	χ²=2.163	0.141
高脂血症	151（40.6）	89（46.1）	62（34.6）	χ²=4.608	0.032
高同型半胱氨酸血症	17（4.6）	7（3.6）	10（5.6）	χ²=0.430	0.512
陈旧性脑梗史	111（29.8）	58（30.1）	53（29.6）	χ²=0.000	1.000
心脏手术史	32（8.6）	12（6.2）	20（11.2）	χ²=2.305	0.129

一般资料	所有患者（372例次）	p-CEA组（193例次）	e-CEA组（179例次）	统计值	P值
年龄（岁， $x ¯$ ±s）	66.48±8.30	66.78±8.80	66.16±7.75	t=0.723	0.470
男性[例（%）]	301（80.9）	156（80.8）	145（81.0）	χ²=0.000	1.000
危险因素[例（%）]
高血压	259（69.6）	134（69.4）	125（69.8）	χ²=0.000	1.000
糖尿病	89（23.9）	43（22.3）	46（25.7）	χ²=0.423	0.515
冠心病	140（37.6）	80（41.5）	60（33.5）	χ²=2.163	0.141
高脂血症	151（40.6）	89（46.1）	62（34.6）	χ²=4.608	0.032
高同型半胱氨酸血症	17（4.6）	7（3.6）	10（5.6）	χ²=0.430	0.512
陈旧性脑梗史	111（29.8）	58（30.1）	53（29.6）	χ²=0.000	1.000
心脏手术史	32（8.6）	12（6.2）	20（11.2）	χ²=2.305	0.129

术后终点指标	所有患者（258例）	p-CEA组（135例）	e-CEA组（123例）	χ²值	P值
死亡	41（15.9）	24（17.8）	17（13.8）	0.487	0.485
所有的心脏事件^*	40（15.5）	16（11.9）	24（19.5）	2.328	0.127
心肌梗死	20（7.8）	8（5.9）	12（9.8）	0.839	0.360
所有的卒中^#	33（12.8）	21（15.6）	12（9.8）	1.456	0.228
术后同侧卒中	11（4.3）	8（5.9）	3（2.4）	1.158	0.282

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