To assess the short-term effect of carotid eversion endarterectomy (CEE) in the treatment of internal carotid artery stenosis and its effect on cognitive function.

A prospective cohort clinical analysis was conducted in 103 patients with internal carotid artery stenosis who underwent CEE from January 2015 to December 2016 in Nanjing Drum Tower Hospital and Xu Zhou Central Hospital. There were 88 males and 15 females, age was (56±8.7) years (range:41-76 years). Preoperative carotid CTA and color Doppler ultrasound were used to assess the degree of stenosis of internal carotid artery. Perioperative bleeding volume and time of blocking carotid artery were recorded. The mini-mental state examination (MMSE) score and Montreal cognitive assessment (MoCA) score were used to assess the cognitive function of patients before and after surgery. Carotid artery ultrasound was used to assess the degree of internal carotid artery stenosis following up for 18 months.

The operative time was (90±27.9) min. The time of carotid artery occlusion during operation was (12±3.1) min, and the intraoperative blood loss was (60±30.6) ml. There were four patients manifesting neurological injury, one cerebral hemorrhage, two cerebral infarction, one cervical hematoma, and two poor wound healing. Restenosis <50% occurred in 1 patient 6 months after surgery. At 12 months after surgery, there were 3 patients with restenosis <50% and 1 patient with restenosis ≥50% and <70%. Four patients showed restenosis <50% 18 months after surgery. Postoperative MoCA score (23.8±4.7) was significantly higher than preoperative score (21.7±2.7, t=4.65, P<0.001). But there was no significant difference in MMSE scores before and after surgery (24.41±2.2vs 25.15±3.76, t=1.72, P=0.086).

CEE has good short-term clinical effect and patency rate in the treatment of internal carotid artery stenosis, and can improve cognitive function.

Internal carotid artery stenosis; Carotid eversion endarterectomy; Restenosis; Cognitive function