title: Discretionary carotid patch angioplasty leads to good results.
abstract: 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.
authors.affiliation: 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
authors.forename: Dolores F
authors.initials: DF
authors.lastname: Cikrit
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Larson
authors.forename: Alan P
authors.initials: AP
authors.lastname: Sawchuk
authors.forename: Connie
authors.initials: C
authors.lastname: Thornhill
authors.forename: Shoaib
authors.initials: S
authors.lastname: Shafique
authors.forename: Ryan D
authors.initials: RD
authors.lastname: Nachreiner
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Lalka
authors.forename: Michael C
authors.initials: MC
authors.lastname: Dalsing
mesh_terms: 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
chemical_list: D011091:Polyesters; D011138:Polytetrafluoroethylene