title: Absorbable suture material in carotid surgery.
abstract: BACKGROUND
  Absorbable sutures are not generally accepted by most vascular surgeons for the fear of breakage of the suture line and the risk of aneurysmal formation, except in cases of paediatric surgery or in case of infections. Aim of this study is to provide evidence of safety and efficacy of the use of absorbable suture materials in carotid surgery.
  
  
  METHODS
  In an 11 year period, 1126 patients (659 male [58.5%], 467 female [41.5%], median age 72) underwent carotid endarterectomy for carotid stenosis by either conventional with primary closure (cCEA) or eversion (eCEA) techniques. Patients were randomised into two groups according to the type of suture material used. In Group A, absorbable suture material (polyglycolic acid) was used and in Group B non-absorbable suture material (polypropylene) was used. Primary end-point was to compare severe restenosis and aneurysmal formation rates between the two groups of patients. For statistical analysis only cases with a minimum period of follow-up of 12 months were considered.
  
  
  RESULTS
  A total of 868 surgical procedures were considered for data analysis. Median follow-up was 6 years (range 1-10 years). The rate of postoperative complications was better for group A for both cCEA and eCEA procedures: 3.5% and 2.0% for group A, respectively, and 11.8% and 12.9% for group B, respectively.
  
  
  CONCLUSIONS
  In carotid surgery, the use of absorbable suture material seems to be safe and effective and with a general lower complications rate compared to the use of non-absorbable materials.
authors.affiliation: 1 University of Ferrara, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Gasbarro
authors.affiliation: 1 University of Ferrara, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Traina
authors.affiliation: 1 University of Ferrara, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Mascoli
authors.affiliation: 1 University of Ferrara, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Coscia
authors.affiliation: 2 University Magna Graecia of Catanzaro, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Buffone
authors.affiliation: 2 University Magna Graecia of Catanzaro, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Grande
authors.affiliation: 3 University of Modena and Reggio Emilia, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Fugetto
authors.affiliation: 2 University Magna Graecia of Catanzaro, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Butrico
authors.affiliation: 2 University Magna Graecia of Catanzaro, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: de Franciscis
authors.affiliation: 2 University Magna Graecia of Catanzaro, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Serra
mesh_terms: D000368:Aged; D000783:Aneurysm / Q000175:diagnosis / Q000209:etiology; D001672:Biocompatible Materials; D002339:Carotid Arteries / Q000601:surgery*; D016893:Carotid Stenosis / Q000175:diagnosis / Q000601:surgery*; D016894:Endarterectomy, Carotid; D004867:Equipment Design; D005260:Female; D006801:Humans; D007558:Italy; D053208:Kaplan-Meier Estimate; D008297:Male; D011100:Polyglycolic Acid; D011126:Polypropylenes; D012008:Recurrence; D012307:Risk Factors; D012720:Severity of Illness Index; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D001672:Biocompatible Materials; D011126:Polypropylenes; D011100:Polyglycolic Acid
keywords: Carotid artery disease; biomaterials; endarterectomy; surgical technique