J Korean Neurosurg Soc.  2020 May;63(3):373-379. 10.3340/jkns.2019.0201.

Eversion Carotid Endarterectomy : A Short Review

• Davidovic
• Tomic IZ

• KMID: 2501725
• DOI: http://doi.org/10.3340/jkns.2019.0201

Abstract

Carotid endarterectomy (CEA) is the main procedure in carotid surgery, as well as the most frequent vascular procedure. Two techniques of CEA are available : eversion and conventional plus patch angioplasty. Eversion CEA is anatomic procedure that reduces ischemic and total operative time. Simultaneous correction of the joined carotid kinking and coiling is possible, easy and safe, while the usage of patch is excluded. Thanks to oblique shape of anastomosis, eversion CEA is associated with low risk of long-term restenosis. The false anastomotic aneurysms occurrence is very rare, almost impossible after eversion CEA. However, the usage of carotid shunt during eversion CEA is not always simple, while proximal or distal extension of the carotid plaque can make eversion CEA more difficult and risky. Eversion CEA should be the first choice in carotid surgery. Conventional CEA is indicated in cases when carotid plaque is extended more than usual, as well as, if the usage of carotid shunt is necessary.

Keyword

Endarterectomy; Eversion; Carotid; Artery

Figure

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  Fig. 1. Atherosclerotic involvement of common carotid artery bifurcation – angiographic review.

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  Fig. 2. De Bakey-Etheredge modification of the eversion carotid endarterectomy : transection of common carotid artery – intraoperative review.

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  Fig. 3. De Bakey-Etheredge modification of the eversion carotid endarterectomy : distal eversion endarterectomy of internal and external carotid artery (A) shematic review and (B) intraoperative review.

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  Fig. 4. De Bakey-Etheredge modification of the eversion carotid endarterectomy : proximal endarterectomy of common carotid artery (A) shematic review and (B) intraoperative review.

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  Fig. 5. De Bakey-Etheredge modification of the eversion carotid endarterectomy : reanastomosis (A) shematic review and (B) intraoperative review.

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  Fig. 6. Atherosclerotic involvement of internal carotid artery – angiographic review.

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  Fig. 7. Kasprzak-Raithel-Vanmaele modification of the eversion carotid endarterectomy : oblique transection of internal carotid artery from the common carotid artery (A) shematic review and (B) intraoperative review.

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  Fig. 8. Kasprzak-Raithel-Vanmaele modification of the eversion carotid endarterectomy : distal endarterectomy of internal carotid artery (A) shematic review and (B) intraoperative review.

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  Fig. 9. Kasprzak-Raithel-Vanmaele modification of the eversion carotid endarterectomy : reattachment of endarterctomized internal carotid artery (A) shematic review and (B) intraoperative review.

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