title: A short incision for carotid endarterectomy results in decreased morbidity.
abstract: OBJECTIVE
  To investigate the effect of a short incision (<5 cm) on the complication rate of the carotid endarterectomy (CEA).
  
  
  METHODS
  A retrospective cohort study.
  
  
  METHODS
  From January 1994 to December 2005, 874 patients underwent 1048 primary carotid endarterectomy (CEA) procedures. Seven hundred and sixty nine operations were performed through a long neck incision (group A), while 279 were performed through a smaller incision (<5 cm) according to a standard protocol (group B). Preoperative and postoperative cranial nerve assessment was completed on all patients. The main outcome measures were stroke, death, cranial and cervical nerve injuries rates.
  
  
  RESULTS
  The 30-day mortality rate was 0.26% in group A and 0.35% in group B (p=.792). The stroke rate was 0.13% and 0% in group A and B respectively (p=.839). The mean length of stay was 2.59 days in group A and 1.67 days in group B (p<.0001). In group A the overall incidence of motor and sensory nerve deficits was 13.5% (104 CEA, 92 patients) but in group B 2.9% (8 CEA, 7 patients, p<.0001, odds ratio [OR] 0.189, 95% confidence interval [CI] 0.091-0.393).
  
  
  CONCLUSIONS
  Carotid endarterectomy through a small incision is a feasible and safe approach that provides cosmetic results and fewer nerve complications without compromising the safety of the procedure.
authors.affiliation: First Department of Surgery, University of Athens Medical School, Laiko General Hospital, Athens, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Bastounis
authors.forename: C
authors.initials: C
authors.lastname: Bakoyiannis
authors.forename: C
authors.initials: C
authors.lastname: Cagiannos
authors.forename: C
authors.initials: C
authors.lastname: Klonaris
authors.forename: C
authors.initials: C
authors.lastname: Filis
authors.forename: E E
authors.initials: EE
authors.lastname: Bastouni
authors.forename: S
authors.initials: S
authors.lastname: Georgopoulos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D020209:Cranial Nerve Injuries / Q000453:epidemiology*; D062109:Dermatologic Surgical Procedures; D016894:Endarterectomy, Carotid / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006115:Greece / Q000453:epidemiology; D006801:Humans; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D009333:Neck; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D020521:Stroke / Q000453:epidemiology* / Q000517:prevention & control; D015996:Survival Rate / Q000639:trends; D014463:Ultrasonography