Late follow-up of carotid endarterectomy with venous patch angioplasty.
Ninety carotid endarterectomies with venous patch angioplasty were performed in 83 patients between July 1980 and December 1985. The primary indication for patching was a small-caliber internal carotid artery (ICA) with a diameter less than 3.0 mm in 54 arteriotomies (60%). Patency of the endarterectomy was evaluated by completion arteriography in all instances. Follow-up was conducted after an intermediate postoperative period of 21 +/- 12.5 months in 69 sides by arteriography. A late follow-up was conducted at 55.4 +/- 11.2 months either by arteriography (in 45 sides) or by carotid duplex scanning (in 11 sides). Twenty-one patients with 23 endarterectomies died, only 1 of a cerebral event. Seven patients moved or refused study and five were lost to follow-up. Three recurrent stenoses and five carotid occlusions developed by the time of the intermediate follow-up. By the time of late follow-up, three additional patients developed recurrent stenoses. Our results suggest that recurrent stenosis continues to develop with a longer period of follow-up in patients undergoing venous patch angioplasty with carotid endarterectomy.
Hans
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Department of Surgery, Macomb Hospital Center, Warren, Michigan.
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000601:surgery*; D002340:Carotid Artery Diseases / Q000601:surgery; D002343:Carotid Artery, Internal; D003251:Constriction, Pathologic; D004691:Endarterectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002546:Ischemic Attack, Transient / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012008:Recurrence; D012501:Saphenous Vein / Q000637:transplantation*; D013997:Time Factors