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Restenosis due to myo-intimal hyperplasia remains a concern after carotid endarterectomy. It occurs in around 6% of cases. Several risk factors for restenosis have already been identified, such as smoking, hypertension, female gender, diabetes, dyslipidemia and small carotid diameter. The main objective of this prospective multicenter study was to determine whether the technical characteristics of the eversion technique have an influence on the rate of restenosis at 1 year.
Between September 2021 and November 2022, we followed all patients undergoing carotid endarterectomy by eversion in 8 French hospitals. Demographic data, operative indications and technical characteristics of the endarterectomies performed were collected. These were defined by the circumferential nature of the carotid bulb according to 3 types (TREC A, B or C), and the length and depth of the endarterectomy according to anatomopathological reports. Post-operative complications were collected as much as doppler ultrasonography at three months and 1 year to quantify restenosis.
Before the surgery, the following data is collected :
Data to be recovered post-operatively from carotid surgery :
The operative report specifying the circumferential nature of the carotid endarterectomy on the common carotid-external carotid axis.
3 possible categories: no endarterectomy, non-circumferential partial endarterectomy, circumferential endarterectomy.
Post-operative doppler (< 1 month) assessing the presence of residual stenosis.
The patient's operative consequences with the occurrence of intercurrent cardiological events (cardiological, biological or electrocardiographic), neurological (central or peripheral), post-operative complications such as cervical hematoma.
Visit between month 1 and month 3 :
Visit at one year :
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| This research does not require any specific investigation and does not imply any modification of treatment. | Procedure | Collection of data from the medical record for patients with a non specific carotid endarterectomy |
| Measure | Description | Time Frame |
|---|---|---|
| Rate of restenosis | The main objective is to evaluate the rate of restenosis at doppler(defined as restenosis ≥50%(NASCET/ECST)) occurring at one year, according to the technical characteristics of the eversion. They are defined according to three distinct criteria: the circumferential nature of the endarterectomy at the level of the carotid bifurcation, the length of the endarterectomy and its depth in the plane of the intima. | one year |
| Measure | Description | Time Frame |
|---|---|---|
| Morbidity and mortality rate | Cumulative morbidity and mortality rate at 30 days defined by:
| 30 days |
| Major cardiological event |
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Inclusion Criteria:
Any patient who is having carotid endarterectomy by eversion according to HAS + ESVS recommendations :
Exclusion Criteria:
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Any patient who is having carotid endarterectomy by eversion
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Gautier HAUPERT, Dr | Contact | 02 41 35 38 38 | gautier.haupert@chu-angers.fr | |
| Elise HOUSSIN | Contact | 02 41 35 61 47 | elise.houssin@chu-angers.fr |
| Name | Affiliation | Role |
|---|---|---|
| Gautier HAUPERT, Dr | university hospital of Angers | Principal Investigator |
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| ID | Term |
|---|---|
| D006965 | Hyperplasia |
| ID | Term |
|---|---|
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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Major cardiological event defined by troponin elevation with chest pain (or equivalent symptom) and/or ECG changes in favor of myocardial ischemia |
| one year |
| Minor neurological events | Minor neurological events: peripheral neurological and/or cranial nerve damage (tongue deviation, dysphonia, swallowing disorder). | one year |