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Eur J Vasc Endovasc Surg. 2007 Jun;33(6):652-6. Epub 2007 Mar 1.

A short incision for carotid endarterectomy results in decreased morbidity.

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1
First Department of Surgery, University of Athens Medical School, Laiko General Hospital, Athens, Greece.

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.

PMID:
17336106
DOI:
10.1016/j.ejvs.2006.12.028
[Indexed for MEDLINE]
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