Bastounis E, Bakoyiannis C, Cagiannos C, Klonaris C, Filis C, Bastouni EE, Georgopoulos S. A Short Incision for Carotid Endarterectomy Results in Decreased Morbidity.
Eur J Vasc Endovasc Surg 2007;
33:652-6. [PMID:
17336106 DOI:
10.1016/j.ejvs.2006.12.028]
[Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2006] [Accepted: 12/23/2006] [Indexed: 11/29/2022]
Abstract
OBJECTIVES
To investigate the effect of a short incision (<5 cm) on the complication rate of the carotid endarterectomy (CEA).
DESIGN
A retrospective cohort study.
PATIENTS AND 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.
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