Optimal surgical technique for carotid endarteroctomy after desobliteration

Here we present the results of our studies aimed at lowering the frequency of restenosis when closing an arteriotomy upon internal carotid artery (ICA) reconstruction. Three methods of performing continuous edge-to-edge suture were used. The first method consists of an initial perpendicular fixating stitch on the edges of the arterial walls, followed by a continuous suture up to the other end. The second method starts with fixating stitches at the arteriotomy edges, followed by two continuous sutures towards each other with a knot in the middle. In the third method, an initial suture is performed fixing the proximal and distal arteriotomy edges, followed by a continuous precision suture going up the edge of the blood vessel. We have perfomed 78 interventions with visual assessment of the result during the operation and measurements of the vessel diameter and lumen size. Remote results were assessed with ultrasound examination after 3, 6 and 12 months. Our data shows that the third variant of continuous suture is the method of choice when performing classical endarterectomy, as it leads to the best remote results.