Patch angioplasty carotid endarterectomy versus eversion carotid endarterectomy

Haris Vukas; Samra Kadić-Vukas; Dragan Piljić; Haris Vranić; Anes Jogunčić; Edina Đozić; Juš Kšela

doi:10.15537/smj.2024.45.7.20240245

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Figure 1
- Consort statement on conscription and randomization of patients
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Figure 2
- Carotid surgery (carotid shunt, eversion carotid endarterectomy, carotid endarterectomy with patch angioplasty, plaque)
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Figure 2
- Days before last verified major cerebrovascular incident( incident/age distribution).

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Table 1

- Occurrence of events at 24 hours, 7 days, and 30 days after surgery

Method	After 24 hours		After 7 days		After 30 days
Method	n (%)	P-value	N (%)	P-value	n (%)	P-value
Arrhythmia
e-CEA	20 (66.7%)	0.01	14 (46.7%)	0.292	9 (30.0%)	0.117
p-CEA	10 (33.3%)	0.01	10 (33.3%)	0.292	4 (13.3%)	0.117
TIA
e-CEA	1 (3.3%)	0.313	1 (3.3%)		0 (0%)
p-CEA	0 (0%)	0.313	1 (3.3%)		0 (0%)
ICV
e-CEA	1 (3.3%)		1 (3.3%)	0.313	0 (0%)	0.315
p-CEA	1 (3.3%)		0 (0%)	0.313	1 (3.3%)	0.315
MI
e-CEA	0 (0%)		0 (0%)		0 (0%)
p-CEA	0 (0%)		0 (0%)		0 (0%)
Cranial nerve dysfunction
e-CEA	11 (36.7%)	0.584	8 (26.7%)	0.095	5 (16.7%)	0.228
p-CEA	9 (30.0%)	0.584	3 (10.0%)	0.095	2 (6.7%)	0.228
Vomiting
e-CEA	9 (30.0%)	0.371	x		x
p-CEA	6 (20.0%)	0.371	x		x
Voice dysfunction
e-CEA	15 (50.0%)	0.297	6 (20.0%)		3 (10.0%)	0.688
p-CEA	11 (36.70%)	0.297	6 (20.0%)		4 (13.3%)	0.688
Bleeding
e-CEA	0 (0%)		0 (0%)		0 (0%)
p-CEA	0 (0%)		0 (0%)		0 (0%)
Carotid occlusion
e-CEA	0 (0%)		0 (0%)		0 (0%)
p-CEA	0 (0%)		0 (0%)		0 (0%)
Neck hematoma
e-CEA	2 (6.7%)		6 (20.0%)	0.278	1 (3.3%)	0.315
p-CEA	2 (6.7%)		3 (10.0%)	0.278	0 (0%)	0.315
Surgical reintervention
e-CEA	0 (0%)		1 (3.3%)	0.301	0 (0%)
p-CEA	0 (0%)		3 (10.0%)	0.301	0 (0%)
Death
e-CEA	0 (0%)		0 (0%)		0 (0%)
p-CEA	0 (0%)		0 (0%)		0 (0%)

e-CEA: eversion carotid endarterectomy, p-CEA: carotid endarterectomy with patch angioplasty, TIA: transitory ischemic attack, ICV: cerebrovascular insult/stroke, MI: myocardial infarction

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Table 2

- Peak systolic velocity, EDV, stenosis level, and plaque characteristics.

	e-CEA/p-CEA
	e-CEA		p-CEA
	Median	IQR^*	Median	IQR^*
PSV (before surgery)	247	198-273	283	215-342
PSV (7 days)	68	64-85	73	62-84
PSV (30 days)	71	61-79	75	67-81
Friedman’s test	45.763		46.308
P	<0.001		<0.001
EDV (before surgery)	119	98-129	124	112-141
EDV (7 days)	28	24-34	33	27-37
EDV (30 days)	30	27-33	31	27-37
Friedman’s test	34.504		45.731
P	<0.001		<0.001
Stenosis level left ICA (before surgery)	58	35-72	73	40-90
Stenosis% level left ICA (7 days)	0	0-30	0	0-25
Stenosis% level left ICA (30 days)	0	0-30	0	0-25
Friedman’s test	32.111		36.00
P	<0.001		<0.001
Stenosis level right ICA (before surgery)	60	45-75	65	45-85
Stenosis% level right ICA (7 days)	0	0-50	20	0-50
Stenosis% level right ICA (30 days)	0	0-45	20	0-50
Friedman’s test	29.673		24.00
P	<0.001		<0.001
Plaque length (mm) (before surgery)	17	14-24	19	15-27
Plaque length (mm) (7 days)	0	0-0	0	0-0
Plaque length (mm) (30 days)	0	0-0	0	0-0
Friedman’s test	60.00		60.00
P	<0.001		<0.001
Plaque thickness (mm) (before surgery)	4.6	3.9-4.9	4.5	3.7-5.8
Plaque thickness (mm) (7 days)	0.0	0-0	0.0	0-0
Plaque thickness (mm) (30 days)	0.0	0-0	0.0	0-0
Friedman’s test	60.00		60.00
P	<0.001		<0.001

e-CEA: eversion carotid endarterectomy, p-CEA: carotid endarterectomy with patch angioplasty,

PSV: peak systolic velocity, EDV: end diastolic velocity, ICA: internal carotid artery, mm: millimeter

↵* IQR: the interquartile range,

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Table 3

- Peak

	Arrhythmia		No DM type2		DM type 2		x2	p
	Arrhythmia		n	%	n	%	x2	p
Before surgery	Extra-beats	No	30	85,70%	17	73,90%	1,258	0,262
	Extra-beats	Yes	5	14,30%	6	26,10%	1,258	0,262
	Atrial arrhythmia	No	31	88,60%	16	69,60%	3,262	0,071
	Atrial arrhythmia	Yes	4	11,40%	7	30,40%	3,262	0,071
	Atrial fibrillation	No	32	91,40%	22	95,70%	0,386	0,535
	Atrial fibrillation	Yes	3	8,60%	1	4,30%	0,386	0,535
	Ventricular arrhythmia	No	36	100,00%	24	100,00%
	Ventricular arrhythmia	Yes	0	0,00%	0	0,00%
During surgery	Extra-beats	No	23	67,60%	13	54,20%	1,086	0,297
	Extra-beats	Yes	11	32,40%	11	45,80%	1,086	0,297
	Atrial arrhythmia	No	22	62,90%	14	58,30%	0,122	0,726
	Atrial arrhythmia	Yes	13	37,10%	10	41,70%	0,122	0,726
	Atrial fibrillation	No	30	83,30%	17	70,80%	1,326	0,250
	Atrial fibrillation	Yes	6	16,70%	7	29,20%	1,326	0,250
	Ventricular arrhythmia	No	36	100,00%	24	100,00%
	Ventricular arrhythmia	Yes	0	0,00%	0	0,00%
24 hours after surgery	Extra-beats	No	29	80,60%	16	66,70%	1,481	0,224
	Extra-beats	Yes	7	19,40%	8	33,30%	1,481	0,224
	Atrial arrhythmia	No	25	69,40%	11	45,80%	3,345	0,067
	Atrial arrhythmia	Yes	11	30,60%	13	54,20%	3,345	0,067
	Atrial fibrillation	No	32	88,90%	19	79,20%	1,068	0,302
	Atrial fibrillation	Yes	4	11,10%	5	20,80%	1,068	0,302
	Ventricular arrhythmia	No	36	100,00%	24	100,00%
	Ventricular arrhythmia	Yes	0	0,00%	0	0,00%
7 days after operation	Extra-beats	No	32	88,90%	17	70,80%	3,135	0,077
	Extra-beats	Yes	4	11,10%	7	29,20%	3,135	0,077
	Atrial arrhythmia	No	26	72,20%	14	58,30%	1,25	0,264
	Atrial arrhythmia	Yes	10	27,80%	10	41,70%	1,25	0,264
	Atrial fibrillation	No	36	100,00%	23	95,80%	1,525	0,217
	Atrial fibrillation	Yes	0	0,00%	1	4,20%	1,525	0,217
	Ventricular arrhythmia	No	36	100,00%	24	100,00%
	Ventricular arrhythmia	Yes	0	0,00%	0	0,00%
30 days after operation	Extra-beats	No	31	86,10%	22	91,70%	0,431	0,511
	Extra-beats	Yes	5	13,90%	2	8,30%	0,431	0,511
	Atrial arrhythmia	No	34	94,40%	20	83,30%	1,975	0,160
	Atrial arrhythmia	Yes	2	5,60%	4	16,70%	1,975	0,160
	Atrial fibrillation	No	35	97,20%	24	100,00%	0,678	0,410
	Atrial fibrillation	Yes	1	2,80%	0	0,00%	0,678	0,410
	Ventricular arrhythmia	No	36	100,00%	24	100,00%
	Ventricular arrhythmia	Yes	0	0,00%	0	0,00%