Comparison of Eversion and Conventional Techniques in Carotid Endarterectomy

NCT07288164 | Completed

• 1 other identifier: KastamanuU
• Study Type: observational
• Target: 129
• Locations: 1 country
• Sites: 1

Brief Summary

Atherosclerotic carotid artery disease is responsible for approximately 20% of strokes worldwide, and its treatment options include medical therapy, surgery, and stenting.Surgical management is prioritized over medical and stent based approaches and can be performed using either the conventional methed closed primarily or with a patch or the eversion technique.The aim of this study was to compare the intraoperative and early postoperative outcomes of the eversion technique and the conventional method with primary closure.

Conditions

Endarterectomy, Carotid; Atherosclerosis Occlusive Disease; Stroke (CVA) or Transient Ischemic Attack

Outcome Measures

Primary Outcomes (2)

• Number of participants with stroke and death

  All strokes and/or deaths occurring within 30 days after surgery

  30 days

• Number of participants with symptoms of occlusion

  Early carotid restenosis or occlusion within 30 days after surgery

  Postoperative 30 days

Study Arms (2)

Conventional endarterectomy

Who were performed conventional,primarily endarterectomy patients are included this group

Procedure: Carotid endarterectomy, conventional

Eversion

Who were performed eversion endarterectomy patients are included this group

Procedure: Carotid endarterectomy, eversion

Interventions

Carotid endarterectomy, eversion PROCEDURE

In this study, patients were divided into two groups according to whether they underwent conventional or eversion endarterectomy. Although the eversion technique is the oldest method, the conventional approach is still widely performed due to its ease of application, despite not being recommended in current guidelines. Therefore, our aim is to contribute to the literature by comparing these two methods.The eversion method is performed by transecting the internal carotid artery (ICA) from the common carotid artery (CCA). The arteriotomy is then closed in an end to side fashion.

Eversion

Carotid endarterectomy, conventional PROCEDURE

In this study, patients were divided into two groups according to whether they underwent conventional or eversion endarterectomy. Although the eversion technique is the oldest method, the conventional approach is still widely performed due to its ease of application, despite not being recommended in current guidelines. Therefore, our aim is to contribute to the literature by comparing these two methods. The conventional method is performed with a longitudinal incision extending from the common carotid artery (CCA) to the internal carotid artery (ICA) up to the end of the plaque. The arteriotomy is then closed either primarily or with the use of a patch. In our study, we performed only the primary closure method..

Conventional endarterectomy

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Carotid endarterectomy was performed in patients with 50-99% stenosis who had experienced stroke or transient ischemic attack (TIA) within the last six months, as well as in asymptomatic patients with 70-99% stenosis. These patients were divided into two groups according to the surgical technique applied conventional or eversion carotid endarterectomy and intraoperative and early postoperative outcomes were compared between the groups.

You may qualify if:

• Patients undergoing isolated carotid endarterectomy, either emergently or electively

You may not qualify if:

• Patients younger than 18 years of age
• Patients scheduled for concomitant cardiac surgery
• Reoperations

Sponsors & Collaborators

• Kastamonu University: lead

Study Sites (1)

Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital

Istanbul, Turkey (Türkiye)

Location

Related Publications (11)

• Ferguson GG, Eliasziw M, Barr HW, Clagett GP, Barnes RW, Wallace MC, Taylor DW, Haynes RB, Finan JW, Hachinski VC, Barnett HJ. The North American Symptomatic Carotid Endarterectomy Trial : surgical results in 1415 patients. Stroke. 1999 Sep;30(9):1751-8. doi: 10.1161/01.str.30.9.1751.

  PMID: 10471419 BACKGROUND

• Wu S, Wang H, Guo J, Zhang F, Pan D, Ning Y, Gu Y, Guo L. Comparative on the effectiveness and safety of different carotid endarterectomy techniques: a single-center Retrospective Study. J Cardiothorac Surg. 2024 Jun 20;19(1):338. doi: 10.1186/s13019-024-02838-0.

  PMID: 38902703 BACKGROUND

• Schneider JR, Helenowski IB, Jackson CR, Verta MJ, Zamor KC, Patel NH, Kim S, Hoel AW; Society for Vascular Surgery Vascular Quality Initiative and the Mid-America Vascular Study Group. A comparison of results with eversion versus conventional carotid endarterectomy from the Vascular Quality Initiative and the Mid-America Vascular Study Group. J Vasc Surg. 2015 May;61(5):1216-22. doi: 10.1016/j.jvs.2015.01.049.

  PMID: 25925539 BACKGROUND

• Jonsson M, Lindstrom D, Wanhainen A, Djavani Gidlund K, Gillgren P. Near Infrared Spectroscopy as a Predictor for Shunt Requirement During Carotid Endarterectomy. Eur J Vasc Endovasc Surg. 2017 Jun;53(6):783-791. doi: 10.1016/j.ejvs.2017.02.033. Epub 2017 Apr 19.

  PMID: 28431821 BACKGROUND

• Ben Ahmed S, Daniel G, Benezit M, Ribal JP, Rosset E. Eversion carotid endarterectomy without shunt: concerning 1385 consecutive cases. J Cardiovasc Surg (Torino). 2017 Aug;58(4):543-550. doi: 10.23736/S0021-9509.16.08495-0. Epub 2015 Feb 12.

  PMID: 25673097 BACKGROUND

• Deser SB, Demirag MK, Kolbakir F. Does surgical technique influence the postoperative hemodynamic disturbances and neurological outcomes in carotid endarterectomy? Acta Chir Belg. 2019 Apr;119(2):78-82. doi: 10.1080/00015458.2018.1459364. Epub 2018 Apr 27.

  PMID: 29701500 BACKGROUND

• Yuruk MA, Ozdemir AC. Eversion versus conventional carotid endarterectomy: A retrospective cohort study. Medicine (Baltimore). 2025 Aug 15;104(33):e43908. doi: 10.1097/MD.0000000000043908.

  PMID: 40826780 BACKGROUND

• Yasa H, Akyuz M, Yakut N, Aslan O, Akyuz D, Ozcem B, Tulukoglu E, Gurbuz A. Comparison of two surgical techniques for carotid endarterectomy: conventional and eversion. Neurochirurgie. 2014 Feb-Apr;60(1-2):33-7. doi: 10.1016/j.neuchi.2013.12.003. Epub 2014 Mar 24.

  PMID: 24673880 BACKGROUND

• Lee JH, Suh BY. Comparative results of conventional and eversion carotid endarterectomy. Ann Surg Treat Res. 2014 Oct;87(4):192-6. doi: 10.4174/astr.2014.87.4.192. Epub 2014 Sep 25.

  PMID: 25317414 BACKGROUND

• Kakisis JD, Antonopoulos CN, Moulakakis KG, Schneider F, Geroulakos G, Ricco JB. Protamine Reduces Bleeding Complications without Increasing the Risk of Stroke after Carotid Endarterectomy: A Meta-analysis. Eur J Vasc Endovasc Surg. 2016 Sep;52(3):296-307. doi: 10.1016/j.ejvs.2016.05.033. Epub 2016 Jul 4.

  PMID: 27389942 BACKGROUND

• Gahremanpour A, Perin EC, Silva G. Carotid artery stenting versus endarterectomy: a systematic review. Tex Heart Inst J. 2012;39(4):474-87.

  PMID: 22949763 BACKGROUND

MeSH Terms

Conditions

Stroke; Ischemic Attack, Transient

Interventions

Endarterectomy, Carotid; Congresses as Topic

Condition Hierarchy (Ancestors)

Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Brain Ischemia

Intervention Hierarchy (Ancestors)

Endarterectomy; Vascular Surgical Procedures; Cardiovascular Surgical Procedures; Surgical Procedures, Operative; Organizations; Health Care Economics and Organizations

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: PROSPECTIVE
• Target Duration: 30 Days
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor Literally: Doctor Teaching Member

Study Record Dates

• First Submitted: December 4, 2025
• First Posted: December 17, 2025
• Study Start: May 15, 2025
• Primary Completion: August 30, 2025
• Study Completion: September 30, 2025
• Last Updated: January 6, 2026

Record last verified: 2026-01

Locations

TU (1)