Patch angioplasty following carotid endarterectomy using the ipsilateral superior thyroid artery.
OBJECTIVE
Synthetic and saphenous vein patches, when used in the carotid territory, are disadvantaged by complications. We tested the feasibility of using a locally harvested artery, the ipsilateral superior thyroid artery (STA), as a source of patching material following carotid endarterectomy (CEA).


METHODS
Twenty-two consecutive patients (15 male) with a median age of 70 (range 53-82) years underwent CEA with an intention to use the STA for patch angioplasty. The STA was harvested via a standard carotid incision and opened longitudinally to fashion a patch.


RESULTS
Of the 22 STAs harvested, only two were rejected due to small calibre. Mean harvesting time was 12 min and there were no immediate complications. Duplex scanning has not revealed restenosis (mean peak velocity = 0.78 [range 0.45-1.16] m/s) in any patient with a median follow-up of 13 (range 3-19) months.


CONCLUSIONS
This technique is quick, convenient and obviates many of the disadvantages associated with conventional patches. Follow-up has shown the technique to be both efficacious and durable in the medium term.
Jenkins
M P
MP
Vascular Unit, Middlesex Hospital, London, U.K.
Aly
S
S
Sarin
S
S
Adiseshiah
M
M
D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000379:methods*; D001158:Arteries / Q000637:transplantation; D016894:Endarterectomy, Carotid; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013961:Thyroid Gland / Q000098:blood supply*; D016896:Treatment Outcome