ISSN 2149-2263 | E-ISSN 2149-2271
Cartoid Near Occlusion: Time to Re-think Endarectomy? [Anatol J Cardiol]
Anatol J Cardiol. 2024; 28(2): 118-123 | DOI: 10.14744/AnatolJCardiol.2023.3779

Cartoid Near Occlusion: Time to Re-think Endarectomy?

Hasan İner1, Orhan Gökalp1, İsmail Yürekli2, Börtecin Eygi2, Çağrı Kandemir2, Tahsin Murat Tellioğlu2, Levent Yılık2, Ali Gürbüz1
1Department of Cardiovascular Surgery, İzmir Katip Çelebi University Faculty of Medicine, İzmir, Türkiye
2Department of Cardiovascular Surgery, İzmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Türkiye

Objectives: Carotid near occlusion (CNO) treatment is still controversial. In the discussion of surgical revascularization of these patients, periprocedural complications and technical failure should be considered in addition to the long-term results. We examined the efficacy and safety of surgical treatment in CNO and non-CNO patients undergoing carotid endarterectomy (CEA).

Methods: Data from 152 patients (118 male and 34 female) who underwent isolated CEA between January 2018 and June 2020 without critical contralateral lesions were retrospectively analyzed. Patients were divided into 2 groups: CNO (n = 52) and non-CNO (n = 100). The groups were compared regarding postoperative transient ischemic attack (TIA), ipsilateral ischemic stroke, and mortality.

Results: The success rate of the procedure was 100% in the CNO group and 99% in the Non-CNO group. In the Non-CNO group, 1 patient had ipsilateral ischemic stroke on postoperative day 0, and this patient was treated with carotid artery stenting. While the number of patients who died in the non-CNO group was 3 (3%) overall, the exitus rate was 1 (1.9%) in the CNO group (P >.05). In the CNO group, retinal TIA was observed in 1 patient (1.9%), ischemic stroke in 2 patients (3.8%), and TIA in 1 patient (1.9%). In the non-CNO group; Retinal TIA was observed in 1 patient (1.0%), ischemic stroke in 2 patients (2.0%), and TIA in 2 patients (2.0%). There was no statistically significant difference between the groups in terms of postoperative neurologic complications and primary endpoints at 12-month follow-up (P >.05).

Conclusions: Carotid endarterectomy is a safe, feasible, and advantageous procedure in selected CNO patients, as in non-CNO carotid artery patients. Therefore, we recommend a surgical approach to prevent neurological events in CNO patients.

Keywords: Carotid artery disease, carotid near occlusion, endarterectomy

Hasan İner, Orhan Gökalp, İsmail Yürekli, Börtecin Eygi, Çağrı Kandemir, Tahsin Murat Tellioğlu, Levent Yılık, Ali Gürbüz. Cartoid Near Occlusion: Time to Re-think Endarectomy?. Anatol J Cardiol. 2024; 28(2): 118-123

Corresponding Author: Hasan İner
Manuscript Language: English

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