Perioperative result of carotid endarterectomies with venous patch angioplasty

Carotid endarterectomy (CEA) is an effective treatment of carotid stenosis to reduce the risk of stroke. The purpose of the current study is to investigate the result of surgical treatment of carotid stenosis in Taipei Veterans General Hospital.

The medical records of 103 patients receiving 113 CEA with or without patch angioplasty in our service between January 1993 and July 1999 were reviewed retrospectively. The clinical and operative variables were collected for analysis. According to the method of carotid arteriotomy closure, all operations were categorized into 3 groups: 76 CEA with venous patch angioplasty, 27 CEA with synthetic angioplasty and 10 primary closure without patch angioplasty. The outcomes of CEA among 3 groups were compared.

There was no significant difference of patient characteristics between 3 groups. Four patients died in the same admission. The incidence of hospital mortality was 0% for venous patch group (p = 0.01), 11.1% for synthetic patch group and 10% for primary closure group. There were 5 perioperative complications including 3 with ipsilateral stroke and 2 with wound hematoma. The incidence of perioperative complication rate was 2.6% for venous patch group, 7.4% for synthetic patch group and 10% for primary closure group (p = 0.87). The incidence of perioperative CVA was 1.3% for venous patch group, 3.7% for synthetic patch group, 10% for primary closure group (p = 0.43).

Our study showed that CEA could be performed with low risk and that venous angioplasty carried lower hospital mortality than other methods of carotid arteriotomy closure.