Shukuzawa K, et al. - Researchers here developed a mini-incision eversion carotid endarterectomy (CEA) procedure (the Jikei method CEA) to prevent perioperative embolic stroke and analyzed perioperative and midterm outcomes after this method. As per observations, the Jikei method CEA proved safe and effective in preventing perioperative and midterm stroke.

Methods

• From January 2006 to June 2014, patients with the Jikei method CEA were evaluated.
• For this study, the primary end point was a major adverse event, which included death, stroke, intracranial hemorrhage, and myocardial infarction, within 30 days of CEA.
• Secondary end-points assessed included postoperative ipsilateral stroke and restenosis.

Results

• A retrospective study of 120 lesions in 110 patients was performed; mean age was 72.2 ± 8.0 years.
• 56/120 lesions (46.7%) were symptomatic and 73/120 lesions (60.8%) showed ≥90% severe stenosis.
• As per observations, the skin incision had mean length of 3.2 ± 0.5 cm.
• In this study, the mean operative time, volume of blood loss, and internal carotid artery clamp time were 171.0 ± 50.7 minutes, 161.6 ± 110.8 mL, and 35.7 ± 10.8 minutes, respectively.
• Three perioperative major adverse events (2.5%) were observed, these included two strokes (1.7%) and one intracranial hemorrhage (0.8%) resulting from hyperperfusion syndrome.
• Observations revealed the median postoperative hospital stay of 6 days (range, 2-303 days).
• Researchers performed follow-up for a mean period of 3.9 ± 2.2 years.
• No case of ipsilateral stroke was encountered during the follow-up period.
• At 5 years, the freedom from ipsilateral stroke was 98.3%.
• Restenosis developed in three lesions (2.5%).
• At 5 years, the freedom from restenosis was 97.2%.
• At 5 years, the freedom from reintervention was 99.0% because carotid artery stent placement was necessary in one patient with severe restenosis.