{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:44:15Z","timestamp":1777941855427,"version":"3.51.4"},"reference-count":16,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Vasc Endovascular Surg"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Carotid endarterectomy (CEA) is a cornerstone in stroke prevention for patients with carotid stenosis, with closure techniques including primary, patch angioplasty, and eversion. The aim of this paper is to present a 10-year analysis of outcomes in patients undergoing primary repair and selective patch angioplasty in CEA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective, single-center study including all consecutive patients undergoing elective CEA at our institution between 2014 and 2023. The Primary outcomes were technical success and 30-day overall survival, ipsilateral ischemic stroke, reintervention, and major adverse cardiac events (MACE) rates. The secondary outcomes were &gt;30-day ipsilateral ischemic stroke, reintervention and primary patency. All outcomes were analyzed in relation to the carotid closure technique (primary closure, patch angioplasty, or eversion). A Generalized Linear Mixed Model (GLMM) was used to assess the association between closure technique and both early and late outcomes. Kaplan-Meier estimates were used to analyze follow-up outcomes depending on the closure technique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 625 CEA procedures were performed on 577 patients [mean age: 71 \u00b1 9\u00a0years; 30.7% female], comprising 87.4% primary repairs, 10.4% patch angioplasty, and 2.2% eversion CEA. Technical success was achieved in (n = 615, 98.4%) of the procedures, with no significant difference between repair types (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      value .947). The mean follow-up duration was 60 \u00b1 38.45\u00a0months. Early (&lt;30-day) ipsilateral stroke and reintervention did not differ significantly across carotid repair groups. GLMM analysis showed that congestive heart failure (CHF) was a significant predictor of increased risk for stroke and MACE (OR: 8.870, CI 95% 2.046-38.451,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .005) (OR: 7.037, CI 95% 1.902-26.038,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .005), respectively. Regional anesthesia significantly lowered the risks of stroke (OR: 0.216, CI 95% .065-.721,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .014) and MACE (OR: 0.380, CI 95% .158-.914,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .032). Long-term (&gt;30-day) ipsilateral stroke and 2-year primary patency were comparable across the groups. GLMM analysis of &gt;30-day stroke revealed no statistically significant differences between patch and primary CEA (OR: 1.947, 95% CI: .321-11.819,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .363). Neither age &gt;80\u00a0years (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 94, 15%) nor female sex (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 177, 30.7%) were significantly associated with increased stroke risk (age: OR 0.524, 95% CI: 0.021-7.013,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .415; sex: OR 0.524, 95% CI: 0.087-3.152,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .370). The analysis of 2-year patency outcomes revealed no significant associations between patch vs primary CEA, sex, or age greater than 80\u00a0years. KM analysis revealed 3-year survival rates of 93% for primary repair, 99% for patch angioplasty, and 90% for eversion (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .5). Stroke-free survival at 3\u00a0years was 95%, 94%, and 100%, respectively (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .3).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>No significant differences were observed in early or late stroke, mortality, or 2-year patency on adjusted analysis. KM analysis showed favourable 3-year freedom from ipsilateral stroke in the primary repair group. These results suggest that primary repair is a safe option in anatomically suitable patients and support a selective, patient-tailored approach to carotid artery closure, rather than a uniform strategy for all cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15385744251360825","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T10:01:17Z","timestamp":1752832877000},"page":"821-828","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Ten-Year Experience With Primary Repair and Selective Patch Angioplasty in Carotid Endarterectomy"],"prefix":"10.1177","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9700-6174","authenticated-orcid":false,"given":"Maysam","family":"Shehab","sequence":"first","affiliation":[{"name":"Meir Medical Center"},{"name":"Tel Aviv University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tzipi","family":"Hornik-Lurie","sequence":"additional","affiliation":[{"name":"Meir Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esra","family":"Abu Much","sequence":"additional","affiliation":[{"name":"Meir Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor","family":"Bilman","sequence":"additional","affiliation":[{"name":"Tel Aviv University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeries","family":"Awwad","sequence":"additional","affiliation":[{"name":"Meir Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adi R.","family":"Bachar","sequence":"additional","affiliation":[{"name":"Meir Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone","family":"Fajer","sequence":"additional","affiliation":[{"name":"Meir Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,7,18]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2021.04.073"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2022.04.011"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1015-9584(11)60016-X"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2020.10.009"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199108153250701"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2010.11.122"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2017.11.077"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2005.06.003"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(25)00107-3"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)01910-3"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.595330"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1024\/0301-1526\/a000957"},{"issue":"10","key":"e_1_3_4_15_2","first-page":"Cd000126","article-title":"Local versus general anaesthesia for carotid endarterectomy","volume":"10","author":"Rerkasem A","year":"2021","unstructured":"Rerkasem A, Orrapin S, Howard DP, Nantakool S, Rerkasem K. 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