DOI: https://doi.org/10.36347/sasjs.2026.v12i02.003

Pages: 137-150

Background: Carotid endarterectomy has been successfully used to treat carotid artery stenosis, using different techniques (eversion and conventional). These techniques have been extensively studied, but the optimal endarterectomy technique for reducing perioperative complications, stroke rates, and recurrent carotid stenosis remains unclear. Objective: The clinical outcomes of carotid endarterectomy are generally evaluated by the preservation of neurological function and a low rate of restenosis. This study aims to compare the clinical outcomes of carotid endarterectomy performed using the eversion and conventional techniques. Methods: We conducted a retrospective study in the vascular surgery department at King Hussein Medical Centre, serving as a signal centre, from November 2017 to February 2025. Patients with extracranial carotid artery stenosis who underwent carotid endarterectomy were included. The choice of technique was determined by technical considerations and the surgeon's preference. A total of 322 CEAs were performed on 296 patients: 35 using the DeBakey eversion technique, 83 with the Kinney/Raithel technique, and 204 with conventional endarterectomy and patch angioplasty (97 autologous, 107 synthetic). Collected data included patient demographics, operative time, mortality, 30-day outcomes, overall complication rate, and comorbidities such as diabetes, coronary artery disease, congestive heart failure, and renal failure. Primary clinical endpoints were perioperative death, transient ischaemic attacks (TIAs), stroke, carotid restenosis or occlusion at the operative site and local complications. Results: The mean operative time was 31 minutes for eversion carotid endarterectomy, 39 minutes for carotid endarterectomy with autologous patch, and 46 minutes for carotid endarterectomy with synthetic patch (P < .01). The 30-day operative mortality rate was 0.8% for eversion CEA and 1.0% for each CEA with autologous and synthetic patch angioplasty (not signif