EVERSION VERSUS CONVENTIONAL CAROTID ENDARTERECTOMY - A PROSPECTIVE-STUDY

Objectives: To analyse comparatively eversion and conventional CEA for later association with restenosis, perioperative stroke/death and ips ilateral cerebrovascular events (early, late, disabling and non-disabl ing). Design: Prospective non-randomised clinical study. Material and Methods: A total of 469 patients underwent 514 procedures; 274 (53%) e version CEA and 240 (47%) conventional CEA. Perioperative monitoring w as carried out by clinical evaluation under local anaesthesia or by tr anscranial Doppler under general anaesthesia. Follow-up was carried ou t by clinical evaluation and Duplex scanning. Results: Clamping time w as significantly shorter in the eversion group (25.5 +/- 7.4 vs. 28.3 +/- 10.1 min; p = 0.0001; CI Delta 4.40/1.12). The perioperative disab ling stroke/death rate was 0.7% for eversion vs. 1.2% for conventional CEA, p = 0.6; odds ratio (OR), 0.58. There were two early carotid res tenosis was significantly lower in the eversion group (2.2% vs. 6.9%, p = 0.03; relative risk reduction 67%). There were no significant diff erences between the two groups relative to new cerebrovascular events (92% in both groups, p = 0.6). Using multivariate analysis (Cox regres sion), eversion CEA, and to a lesser extent standard CEA with patch, a ppeared to protect the vessel from restenosis. Conclusions: The eversi on technique was associated with reduced clamping time and probability of restenosis. However, because of the nature of a non-randomised stu dy, the present analysis should be confirmed by a multicentre randomis ed trial.