Abstract

Aim: This study aimed to evaluate long-term clinical outcomes after Modified Partial Eversion Carotid Endarterectomy (MPE-CEA) and to determine prognostic factors associated with all-cause mortality.
Material and Methods: A retrospective analysis was conducted on 55 consecutive patients aged ≥50 years who underwent MPE-CEA between January 2020 and December 2023 at a single center. The mean follow-up duration was 27 months, with all-cause mortality designated as the primary outcome. Survival was assessed with Kaplan–Meier analysis, while predictors of mortality were examined using Cox proportional hazards models.
Results: The mean age of the patients was 68.45 ± 9.34 years, and 70.9% were male; chronic kidney disease (CKD) was present in 9.1% of patients. No stroke, cranial nerve injury, or in-hospital mortality was observed in the postoperative period, while one patient (1.8%) required surgical revision due to hematoma. According to the survival analysis, the estimated overall survival rates at 3 and 5 years were 82.3% and 70.5%, respectively. The presence of CKD was associated with poorer survival, with a two-year estimated survival of 40% in patients with CKD (p < 0.001). In the multivariate analysis, CKD was identified as the only independent predictor of mortality (HR: 10.446; 95% CI: 1.257–86.777; p = 0.030).
Conclusion: MPE-CEA was associated with low perioperative complication rates in this cohort. Chronic kidney disease emerged as the only independent predictor of long-term all-cause mortality, identifying a high-risk subgroup that may require closer multidisciplinary follow-up.

Key words: Carotid endarterectomy, modified partial eversion, chronic kidney disease, all-cause mortality, prognostic factor