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KMID : 0904020100260010030
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Journal of Korean Society for Vascular Surgery
2010 Volume.26 No. 1 p.30 ~ p.35
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Early Results of Eversion Carotid Endarterectomy
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Song In-Chul
Kim Hyung-Kee
Hwang Yang-Ha
Choi Hyang-Hee
Huh Seung
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Abstract
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Purpose: Eversion carotid endarterectomy (ECEA) has been used in western countries with acceptable early and late results. However, there has been no report of ECEA in Korea with regard to its safety and efficacy. The goal of the present study was to determine the early results of ECEA in Korea.
Methods: From October 2008 to December 2009, 19 ECEAs were performed on 18 patients by one vascular surgeon. The patient data and radiology results were prospectively collected according to the hospital protocol. The frequency of early postoperative stroke, myocardial infarction and mortality were evaluated. In addition, the frequency of procedure-induced new brain lesions (NBL) detected by diffusion-weighted MRI (DW-MRI) within one day after the procedure and the post-procedural complications were evaluated.
Results: All ECEAs were performed under regional anesthesia; shunts were not necessary in any of the cases. Among a total of 19 ECEAs, there were no cases of early postoperative stroke, myocardial infarction or mortality. Other early postoperative complications included one case of temporary cerebral hyperperfusion syndrome and two hematomas that spontaneously resolved. No NBL was detected on the postoperative DW- MRI. The external carotid artery lesion was aggravated in five cases and was detected on CT angiography before discharge.
Conclusion: The results of this study showed no strokes or NBLs after ECEA under regional anesthesia. ECEA may be used safely for the management of atherosclerotic severe carotid stenosis in Korean patients; however, further study for long-term complications of ECEA is necessary.
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KEYWORD
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Carotid stenosis, Endarterectomy, Eversion, Complications
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