Carotid Artery Diameters, Carotid Endarterectomy Techniques and RestenosisGiovanni Bertoletti1, Alessandro Varroni1, Maria Misuraca1, Marco Massucci1, Antonio Pacelli2, Marco Ciacciarelli2and Luigi Iuliano2*
- *Corresponding Author:
- Luigi Iuliano, MD
Sapienza University of Rome
Department of Medico-Surgical Sciences and Biotechnologies
Vascular Biology, Atherothrombosis & Mass Spectrometry Lab
corso della Republica 79, 04100 Latina, Italy
Tel: +39 0773 1757231
Fax: +39 0662 291089
E-mail: [email protected]
Received Date: June 26, 2013; Accepted Date: September 16, 2013; Published Date: September 18, 2013
Citation: Bertoletti G, Varroni A, Misuraca M, Massucci M, Pacelli A, et al. (2013) Carotid Artery Diameters, Carotid Endarterectomy Techniques and Restenosis. J Vasc Med Surg 1:114. doi: 10.4172/2329-6925.1000114
Copyright: © 2013 Bertoletti G, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Restenosis of the carotid artery is a major complication of carotid endarterectomy (CEA). The purpose of this study was to examine the role of CEA techniques on carotid dimensions variation, postoperative versus preoperative multi-segmental diameters and its impact on the development of restenosis at 12 months follow up.
Methods: 175 consecutive patients eligible for carotid surgery were included in the study. 75 underwent CEA by patch reconstruction (PR), 53 by eversion (EV) and 47 by primary closure (PC). Before the procedures and at discharge, carotid diameters were measured at four reference points (common carotid, CC; carotid bulb, CB; proximal internal carotid artery, PICA; distal internal carotid artery, DICA) by ultrasonography. The rate of minor (< 50%) and major (≥ 50%) restenosis was evaluated at 12 months follow up.
Results: PR produced an increase in all carotid diameters while PC and EV produced a decrease in carotid diameters, having PC affected all diameters while EV affected CB and PICA diameter. However, postoperative diameters had comparable dimension independently of the surgical technique used. The rate of overall and major restenosis did not differ significantly between the three types of surgery. Logistic regression analysis showed that female gender was associated with major restenosis (OR 6.9, 95% CI 1, 23 – 38, 49) irrespective of surgical technique.
Conclusion: This study shows that carotid diameters and restenosis rate after CEA are comparable whatever is the surgical technique adopted, and that women are at high risk of major restenosis.