Miniskin Incision for Carotid Endarterectomy: Neurological Morbidity and Health-Related Quality of Life

Giovanni Giannace, Massimiliano Walter Guerrieri, Carlo Setacci

VASCULAR SURGERY UNIVERSITY OF SIENA, SIENA, Italy

Date, time and location: 2018.05.25 15:30, Congress Hall, 2F–B

Abstract

OBJECTIVES: Cranial or cervical nerve injury is recognized as possible complication after CEA, making less invasive alternative as carotid stenting more attractive.To investigate the effect of a mini skin incision (<5 cm) on the cranial and cervical nerve injury after carotid endarterectomy (CEA) in comparison to standard longitudinal incision in a high volume center, and to evaluate health-related quality of life (HRQOL) outcomes in those patients who had undergone both type of skin incision.

RESULTS:The stroke and death rate at 30 days was 1.18% in group A and 0.95% in group B (P=1).The incidence of cranial and cervical nerve deficits was significantly lower in group B (5.7%) in comparison to group A (15.4%) (P < .0001, odds ratio [OR] 0.331, 95% confidence interval [CI] 0.18-0.49). Cervical hematoma was more common after standard incision (5.2% vs 1.2%, P=.004) HRQOL at 1 month in subgroup B showed that changes in SF-36 subscale scores were similar after standard and mini-invasive approach. On the disease-specific scales, the outcomes after mini-skin incision were significantly better for less difficulty with eating/swallowing and neck pain (p = 0.01).

CONCLUSIONS:CEA through a short incision provides no additional peri-procedural neurologic risks an fewer cranial and cervical nerve complications.As validated by patients with bilateral disease who experienced both surgical techniques, mini-skin incision is also associated with better health-related quality of life at 1 month, particularly with regard to eating/swallowing and neck pain.