title: Use of the vascu-guard bovine pericardium patch for arteriotomy closure in carotid endarterectomy. Early and long-term results.
abstract: BACKGROUND
  To report the early and long-term results of Vascu-Guard bovine pericardium (BP) for patch angioplasty in carotid endarterectomy (CEA).
  
  
  METHODS
  We retrospectively analyzed the data of 256 CEAs with BP patch closure performed in 238 patients during the past 12 years in our department. Patch-related complications (restenosis, infection, and aneurysm formation) and early and late (12 to 144 months follow-up) clinical outcomes were recorded and statistically analyzed.
  
  
  RESULTS
  Thirty-day postoperative stroke rate was 1.2% (3/256) with zero mortality. Major complications occurred in 3.5% (9 of 256) of the procedures and cranial nerve injury in 4.3% (11 of 256). At 12 years, cumulative estimates of freedom from any stroke, stroke-free survival, and freedom from restenosis were 88.4% (standard error [SE]: 3.3%), 60% (SE: 7.8%), and 98.3% (SE: 0.8%), respectively. No patient experienced patch infection or aneurysm formation.
  
  
  CONCLUSIONS
  This series shows the efficacy, safety, and durability of CEA with BP patch closure, in both the short and long term. BP combines the advantages of vein and synthetic patches, representing a suitable option when performing CEA.
authors.affiliation: Department of Surgery-Vascular Surgery Unit, Medical School, University of Ioannina, Ioannina, Greece.
authors.forename: John C
authors.initials: JC
authors.lastname: Papakostas
authors.affiliation: Department of Surgery-Vascular Surgery Unit, Medical School, University of Ioannina, Ioannina, Greece.
authors.forename: Stavros
authors.initials: S
authors.lastname: Avgos
authors.affiliation: Department of Anesthesiology, Medical School, University of Ioannina, Ioannina, Greece.
authors.forename: Eleni
authors.initials: E
authors.lastname: Arnaoutoglou
authors.affiliation: Department of Neurology, Medical School, University of Ioannina, Ioannina, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Nassis
authors.affiliation: Department of Surgery-Vascular Surgery Unit, Medical School, University of Ioannina, Ioannina, Greece.
authors.forename: Michalis
authors.initials: M
authors.lastname: Peroulis
authors.affiliation: Department of Surgery-Vascular Surgery Unit, Medical School, University of Ioannina, Ioannina, Greece.
authors.forename: Christina
authors.initials: C
authors.lastname: Bali
authors.affiliation: Department of Anesthesiology, Medical School, University of Ioannina, Ioannina, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Papadopoulos
authors.affiliation: Department of Surgery-Vascular Surgery Unit, Medical School, University of Ioannina, Ioannina, Greece. Electronic address: milmats@gmail.com.
authors.forename: Miltiadis I
authors.initials: MI
authors.lastname: Matsagkas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000379:methods*; D000818:Animals; D016893:Carotid Stenosis / Q000175:diagnosis / Q000601:surgery*; D002417:Cattle; D016894:Endarterectomy, Carotid / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000637:transplantation*; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex