Results of using the modified technique of eversion carotid endarterectomy in patients with extended atherosclerotic disease of bifurcation of common carotid artery

BACKGROUND: Eversion carotid endarterectomy is one of the most frequently used methods of carotid endarterectomy. This is primarily due to the relative ease of surgical techniques, reduction in the risk of hemodynamic disorders in the reconstruction zone and the absence of the need to use synthetic material. The main disadvantage of eversion carotid endarterectomy is poor visualization of the distal edge of the atherosclerotic plaque and the lack of control of the unfixed edge of intima in common atherosclerotic lesion of the internal carotid artery. The use of a modified technique of eversion carotid endarterectomy avoids these disadvantages and preserves its advantages. AIM: to analyze the results of the use of modified eversion carotid endarterectomy in patients with extended disease to the internal carotid artery. MATERIALS AND METHODS: The study is based on the analysis of the results of treatment of patients with chronic cerebrovascular insufficiency due to extended atherosclerotic disease of the internal carotid artery, in whom eversion carotid endarterectomy was performed using a modified technique in the conditions of the Department of Vascular Surgery in Vinogradov City Hospital. The presence of an atherosclerotic plaque extending over a distance of more than 2.5 cm from the bifurcation was considered a common damage to the internal carotid artery. The assessment of intraoperative parameters, early postoperative period, as well as treatment results after 3, 6 and 12 months from the moment of surgery was carried out. RESULTS: The results of treatment of 60 patients in the early postoperative and long-term periods were analyzed. The average operation time was 71.37 ± 8.87 minutes. The average time for clamping the ICA was 18.35 ± 3.9 minutes. Transient ischemic attack in the early postoperative period occurred in 1 (1.7%) patient. Restenosis of the internal carotid artery (≥40%) on the side of the performed reconstruction developed in 3 (5.2%) patients. CONCLUSION: The risk of development of neurological disorders in the early postoperative period, as well as of restenosis of the area of surgical intervention in the long-term period when using the modified technique of eversion carotid endarterectomy, correspond to the data of modern world literature.