title: Carotid patch and cerebrovascular event relation after carotid endarterectomy procedure.
abstract: BACKGROUND
  Carotid endarterectomy (CEA) is the treatment of choice for patients with symptomatic and asymptomatic high-grade carotid stenosis. In literature there are papers advocating patch plasty for better results. But there is controversy about which patch material is optimal for use. This study compared rate of neurologic events, and perioperative death in patients undergoing CEA with primary closure versus patch closure.
  
  
  METHODS
  We compared patch angioplasty to primary closure between August 2008 and December 2012 in 57 operations. Patients grouped according to their closure technique. Early (30-day) stroke and mortality rate were evaluated. Mean age of patients was 67.79±10.19 (range 41-85 years). 15 (26.31%) of patients were female.
  
  
  RESULTS
  Primary closure was used in 13 operations, and patch angioplasty was used in 44 (saphenous vein: 5, Dacron: 23, Fabric: 5, Carotid: 11). There were no significant differences among groups' baseline characteristics. Primary closure was associated with significantly more postoperative major stroke compared with patch used closure (P=0.05). None of preoperative variables were associated with postoperative stroke.
  
  
  CONCLUSIONS
  On the basis of our results, avoiding primary closure for CEA is defendable. But choice of patch material needs large trials to conclude.
authors.affiliation: Konya Education and Research Hospital Cardiovascular Surgery Department, Konya, Turkey - ka97084@yahoo.com.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kalender
authors.forename: Mehmet
authors.initials: M
authors.lastname: Taşar
authors.forename: Okay G
authors.initials: OG
authors.lastname: Karaca
authors.forename: Ata N
authors.initials: AN
authors.lastname: Ecevit
authors.forename: Osman T
authors.initials: OT
authors.lastname: Darçin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D016894:Endarterectomy, Carotid / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D011474:Prosthesis Design; D012189:Retrospective Studies; D012307:Risk Factors; D012501:Saphenous Vein / Q000637:transplantation*; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D011093:Polyethylene Terephthalates