Discretionary carotid patch angioplasty leads to good results
Presented at the 30th Annual Surgical Symposium of the Association of VA Surgeons, Cincinnati, Ohio, May 7–9, 2006
Received 9 May 2006; received in revised form 10 August 2006
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.
Department of Surgery, Division of Vascular Surgery, Richard L. Roudebush Veteran’s Hospital, Indiana University School of Medicine, Department of Surgery, Third Floor, 1001 W. Tenth St., Indianapolis, IN 46202, USA
ABSTRACT