Discretionary carotid patch angioplasty leads to good results.
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.
Cikrit
Dolores F
DF
Department of Surgery, Division of Vascular Surgery, Richard L. Roudebush Veteran's Hospital, Indiana University School of Medicine, Third Floor, 1001 W. Tenth St., Indianapolis, IN 46202, USA. dcikrit@iupui.edu
Larson
Dawn M
DM
Sawchuk
Alan P
AP
Thornhill
Connie
C
Shafique
Shoaib
S
Nachreiner
Ryan D
RD
Lalka
Stephen G
SG
Dalsing
Michael C
MC
D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D019917:Blood Vessel Prosthesis Implantation; D002343:Carotid Artery, Internal; D016893:Carotid Stenosis / Q000453:epidemiology / Q000601:surgery; D015897:Comorbidity; D003327:Coronary Disease / Q000453:epidemiology; D016894:Endarterectomy, Carotid / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D011091:Polyesters; D011138:Polytetrafluoroethylene; D011183:Postoperative Complications / Q000453:epidemiology; D012008:Recurrence; D012189:Retrospective Studies; D020521:Stroke; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex
D011091:Polyesters; D011138:Polytetrafluoroethylene