title: The modified operative technique of partial eversion carotid endarterectomy.
abstract: We report a modified operative technique termed partial eversion carotid endarterectomy (PECE). During a 9-year period (2006-2015), 352 patients underwent PECE. Indications for surgery, intraoperative details, and outcomes were recorded. The initial 185 patients had carotid duplex ultrasound imaging at 6 weeks and then at 6, 12, and 24 months. Subsequent patients had carotid imaging at 4 to 6 weeks. Indications included stroke (76), transient ischemic attack (153), and amaurosis fugax (33); 58 patients were asymptomatic, and 32 patients had surgery before cardiac surgery. Median clamp time was 14 minutes (interquartile range, 11.5-17 minutes). Median total operation time was 41 minutes (interquartile range, 31-72 minutes). Outcomes included four transient ischemic attacks (1.2%), five strokes (1.4%), and two deaths at 30 days (0.5%). No significant cranial nerve injuries or carotid restenosis was detected during follow-up. PECE is technically straightforward, with outcomes comparable to those of current operative techniques. Its advantages included reduced operative and carotid clamping time.
authors.affiliation: Department of Vascular Surgery, Royal Blackburn Hospital, Blackburn, United Kingdom.
authors.forename: Richard
authors.initials: R
authors.lastname: McBride
authors.affiliation: Department of Vascular Surgery, Royal Blackburn Hospital, Blackburn, United Kingdom. Electronic address: john.porter@doctors.org.uk.
authors.forename: Johnathan
authors.initials: J
authors.lastname: Porter
authors.affiliation: Department of Vascular Surgery, Royal Blackburn Hospital, Blackburn, United Kingdom.
authors.forename: Haytham
authors.initials: H
authors.lastname: Al-Khaffaf
mesh_terms: D000368:Aged; D020757:Amaurosis Fugax / Q000209:etiology; D058070:Asymptomatic Diseases; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D000072226:Computed Tomography Angiography; D016894:Endarterectomy, Carotid / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000209:etiology; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex