Vessel wall and flow characteristics after carotid endarterectomy: eversion endarterectomy compared with Dacron patch plasty.
OBJECTIVE
Experimental studies have demonstrated that decreases in vessel wall compliance and increases in turbulence may contribute to (re)stenosis. We studied vessel wall and flow characteristics after endarterectomy with Dacron patch plasty and after eversion endarterectomy, and compared those findings with the characteristics of non-stenotic, unoperated carotid arteries (controls).


METHODS
Seventy-four patients who underwent 84 carotid endarterectomies were studied postoperatively by ultrasonography (2-24 months) Recorded variables included the diameter of the bulb, strain, elastic modulus (stiffness), and presence of turbulent flow.


RESULTS
The vessel wall and flow characteristics of the two groups differed significantly. The diameter was higher and the strain lower in Dacron patch plasty than in controls; eversion endarterectomy did not differ from controls. The elastic modulus was higher (stiffer) in Dacron patch plasty than in eversion endarterectomy; neither Dacron patch plasty nor eversion endarterectomy differed significantly from controls. The stiffness index was not significantly different between the groups. Turbulence was present in Dacron patch plasty and eversion endarterectomy when compared with controls.


CONCLUSIONS
In diameter, strain and stiffness, the operated carotid artery resembles the non-stenotic, unoperated artery more closely after eversion endarterectomy than after Dacron patch plasty.
Baan
J
J
St. Luke's Episcopal Hospital, Department of Cardiovascular Surgery, Houston, TX 77225-0269, USA.
Thompson
J M
JM
Reul
G J
GJ
Cooley
D A
DA
Brand
R
R
Henderson
M C
MC
van Baalen
J M
JM
van Bockel
J H
JH
D000368:Aged; D000369:Aged, 80 and over; D002343:Carotid Artery, Internal; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016022:Case-Control Studies; D003187:Compliance; D016894:Endarterectomy, Carotid / Q000009:adverse effects / Q000379:methods*; D005260:Female; D018056:Hemorheology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D012008:Recurrence; D012307:Risk Factors; D018615:Ultrasonography, Doppler, Color
D011093:Polyethylene Terephthalates