Discretionary carotid patch angioplasty leads to good results

Cikrit, Dolores F.; Larson, Dawn M.; Sawchuk, Alan P.; Thornhill, Connie; Shafique, Shoaib; Nachreiner, Ryan D.; Lalka, Stephen G.; Dalsing, Michael C.

doi:10.1016/j.amjsurg.2006.08.027

« Previous Next »The American Journal of Surgery
Volume 192, Issue 5 , Pages e46-e50, November 2006

Discretionary carotid patch angioplasty leads to good results

Presented at the 30th Annual Surgical Symposium of the Association of VA Surgeons, Cincinnati, Ohio, May 7–9, 2006

Department of Surgery, Division of Vascular Surgery, Richard L. Roudebush Veteran’s Hospital, Indiana University School of Medicine, Department of Surgery, Third Floor, 1001 W. Tenth St., Indianapolis, IN 46202, USA

Received 9 May 2006; received in revised form 10 August 2006

Abstract

Background

This study evaluated the type and need for angioplasty in 253 consecutive carotid endarterectomies.

Methods

Polyester knitted gelatin sealed patch (DP) and polytetrafluoroethylene (PTFE) patches were used in, respectively, 159 and 29 patients, with 65 vessels closed primarily (no patch [NP]).

Results

Surgical results, estimated blood loss, and surgical time were similar in each group. Postoperative hematomas occurred in 6 DP and 3 NP patients. There were 3 strokes in the DP group. Long-term duplex evaluation was possible in 201 patients. The number of patients who had less than 15%, 15% to 50%, 50% to 79%, 80% to 99%, 100%, or an ungraded degree of narrowing were as follows for each group: DP, 117, 2, 5, 0, 1, and 2; PTFE, 18, 1, 1, 0, 0; and NP, 53, 0, 0, 0, 1. Statistical analysis failed to show any difference between groups postoperatively or in long-term follow-up evaluation.

Conclusions

It appears that selective patching is safe and effective in male patients who undergo carotid endarterectomy. The type of patch material also is inconsequential. Patch type and its use should be at the surgeon’s discretion.

Keywords: Carotid endarterectomy, Patch angioplasty, Carotid stenosis