Autogenous common facial vein or external jugular vein patch for carotid endarterectomy

The purpose of this study was to determine whether common facial vein or external jugular vein are as good a vein patch as a saphenous vein for carotid patch angioplasty.

Retrospectively, 19 patients who underwent everted common facial vein or external jugular vein patch were compared with 199 patients who underwent saphenous vein patch carotid endarterectomy during 1989 to 1996. The two groups were compared clinically and by sonographic surveillance. The mean follow-up was 18+/-4 months for common facial vein/external jugular vein patients and 48+/-15 months for saphenous vein patch group.

No significant differences in mortality or morbidity were observed among patients in whom everted common facial vein or external jugular vein was used as compared with saphenous vein. No bleeding, thrombotic event, dilation of the patch or aneurysmal degeneration and perioperative deaths occurred in either of the two groups. Duplex surveillance studies showed no significant difference in recurrent moderate (50-79%) and severe (80-99%) stenosis.

Everted common facial vein or external jugular vein patch was comparable to other vein patches. This eliminates the comorbidity of groin incision. Also, using everted common facial vein or external jugular vein as vein patch saves saphenous vein to be used for other vascular procedures, such as coronary artery or lower extremity bypass.