Is primary closure still a reliable technique in carotid endarterectomy?

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Şahin A., Dernek S.

Cardiovascular Surgery and Interventions, vol.7, no.3, pp.152-156, 2020 (Peer-Reviewed Journal)


Objectives: This study aims to evaluate perioperative and long-term results of carotid endarterectomy (CEA) in terms of primary closure and patch techniques.

Patients and methods: This retrospective study included a total of 289 patients (145 males, 144 females; mean age 64.9±3.85 years; range, 53 to 84 years) who underwent elective CEA in our clinic between January 2014 and January 2019. The patients were divided into two groups as Group 1 consisting of patients who received patch closure (n=62) and Group 2 consisting of patients who received primary closure (n=227). Both groups were compared in terms of demographic and clinical data, and postoperative results.

Results: There was no significant difference between the groups in terms of demographic characteristics. The mean cross-clamp time was significantly shorter in Group 2 (p=0.001). The rate of hematoma formation was higher in Group 1 (p=0.048), while acute myocardial infarction (p=0.431), stroke in the short-term (p=0.839) and long-term (p=0.429), development of restenosis ≥70% (p=0.839), and mortality rates (p=1.0) did not differ significantly between the groups.

Conclusion: Our study results indicate that the application of patch or primary closure techniques during CEA has no significant superiority to each other in the early- and mid-term. In eligible cases and in whom the arterial diameter is over 5 mm, primary closure can be performed safely.