The impact of vein patch angioplasty on long-term surgical outcome after carotid endarterectomy. A prospective follow-up study with serial duplex scanning.
In 304 patients the natural history of 339 endarterectomized and 269 nonoperated internal carotid arteries was examined by means of ultrasonic Duplex scanning over a period of 60 months. In 172 cases the operated artery was closed primarily and venous patching was performed in 167 endarterectomies. By life-table analysis the rate of significant recurrent stenosis (more than 50% diameter reduction) during the first year was respectively 3.4% for male and 4.3% for female patched arteries. For primarily closed vessels these numbers were respectively 14.5% for male and 24.4% for female arteries. More than 1 year after surgery, no significant difference between the 4 groups was demonstrated and the mean annual rate of recurrent stenosis amounted to 1.7%. For the nonoperated arteries, no significant difference between the first and the remaining 4 years of follow-up could be demonstrated. For these vessels the mean annual rate of progression to stenosis greater than 50% diameter reduction was 11.2%.
Ten Holter
J B
JB
Department of Neurophysiology, S. Antonius Hospital, Nieuwegein, The Netherlands.
Ackerstaff
R G
RG
Thoe Schwartzenberg
G W
GW
Eikelboom
B C
BC
Vermeulen
F E
FE
Van den Berg
E C
EC
D001161:Arteriosclerosis / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D002340:Carotid Artery Diseases / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000473:pathology / Q000601:surgery; D004691:Endarterectomy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012501:Saphenous Vein / Q000637:transplantation*; D013997:Time Factors; D014463:Ultrasonography