Primary closure after a carotid endarterectomy.
OBJECTIVE
The prevalences of restenosis and stroke after a carotid endarterectomy (CEA) tend to differ substantially according to the surgeon. Primary closure after a CEA was the routine procedure in our institute. The primary objectives of this study were to compare the results of patients of a primary arteriotomy closure in CEA between our own and others' results based on the findings in the literature.


METHODS
One hundred and sixty-six patients who underwent a primary closure were analyzed. Perioperative neurologic deficits were determined by the neurologist. Restenosis was defined as >50% stenosis on duplex scan. The range of follow-up was 7-112 months.


RESULTS
Stroke including transient ischemic attack occurred within 30 postoperative days in 3 patients and after 30 postoperative days in 1 of the 166 patients. Five patients showed >50% asymptomatic restenosis. Two patients were treated with stent insertion and one underwent reoperation. One patient showed total occlusion during the follow-up period without any neurological deficits. One patient showed 50%-70% stenosis, and no intervention was done.


CONCLUSIONS
The rates of recurrent stenosis and postoperative stroke were found to be sufficiently low following a primary closure to justify the continued use of this technique.
Kim
Dong-Ik
DI
Division of Vascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwondong, Kangnamku, Seoul 135-710, South Korea.
Moon
Ji-Young
JY
Lee
Chul-Hyung
CH
Kim
Do-Yool
DY
Jang
Young-Sam
YS
Kim
Gyeong-Moon
GM
Chung
Chin-Sang
CS
Lee
Kwang-Ho
KH
Kim
Seon-Woo
SW
D000368:Aged; D016893:Carotid Stenosis / Q000209:etiology / Q000601:surgery*; D016894:Endarterectomy, Carotid / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D020521:Stroke / Q000209:etiology