International Society For Minimally Invasive Cardiothoracic Surgery

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Carotid Endarterectomy By Small Incision
Que K. Do, Trung A. Nguyen.
Thong Nhat hospital, Ho Chi Minh, Viet Nam.

Background:Carotid endarterectomy is effective method for preventing stroke due to carotid stenosis. Temporary shunt is standard in carotid endarterectomy for brain protection with 6-10 cm incision. Shunt - induced complications has been reported so that some authors perform carotid endarterectomy without shunt. Small incision 3-4 cm could be benefit for patients who underwent carotid endarterectomy without shunt.The purpose of this study was review our experiences on carotid endarterectomy without shunt by small incision in Thongnhat hospital during 10 years. Methods:Prospective study. Evaluate the clinical characteristics of stenosis of the carotid. Carotid endarterectomy without shunt by small incision was performed for all of cases with conventional carotid endarterectomy or Eversion carotid endarterectomy.Primary outcomes are mortality rates, stroke rates at 1 month and 1 year after operation Results:During 10 years from 2007 to 2017, 500 carotid endarterectomy were done in Thong nhat hospital. Mean age is 70.2 range 46 - 92, male : female ratio is 4:1. Previous stroke in 54.8% of cases. Bilateral carotid stenosis in 16.4%. Atherosclerosis are the cause of all cases. All of patients were diagnosed by Duplex scan and CTA. Mean clamp time is 22.4 minus. Three patients (0.6%) died by AMI, and pneumonia in 1 month postoperative period, Four patients (0.8%) had stroke in 1 month after operation. After 1 years follow up, 1 year mortality rates is 0.6 % (3 cases), stroke rates is 0.2%%, restenosis is 1.2%.Conclusions:Carotid endarterectomy without shunt by small incision is the safe and effective methods for preventing stroke due to stenosis of carotid artery. Key words:Carotid stenosis, stroke, carotid endarterectomy, eversion carotid endarterectomy.


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