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Published on: July 9, 2020
Patch angioplasty versus primary closure for carotid endarterectomy
R Bond1, K Rerkasem, A F AbuRahma
1Stroke Prevention Research Unit, Gibson Building, Radcliffe Infirmary, Woodstock Road, Oxford, OXON, UK, OX2 6HE.
The Cochrane Database of Systematic Reviews
|April 24, 2004
Summary
Carotid patch angioplasty may reduce the risk of stroke and restenosis after carotid endarterectomy. This procedure appears to lower the combined risk of death or stroke, with a trend towards reduced mortality.
Area of Science:
- Vascular Surgery
- Neurology
- Cardiology
Background:
- Carotid endarterectomy is a procedure to remove plaque from carotid arteries.
- Carotid patch angioplasty, using venous or synthetic material, may prevent restenosis and stroke.
Purpose of the Study:
- To evaluate the safety and efficacy of carotid patch angioplasty versus primary closure after carotid endarterectomy.
- To compare routine or selective patch angioplasty outcomes.
Main Methods:
- Systematic review of randomized and quasi-randomized trials.
- Searched multiple databases including Cochrane Stroke Group Trials Register, MEDLINE, and EMBASE.
- Two independent reviewers assessed trial eligibility, quality, and extracted data.
Main Results:
- Carotid patch angioplasty reduced the risk of stroke (OR=0.33) and perioperative arterial occlusion (OR=0.15).
- The procedure also decreased restenosis (OR=0.20) and combined death or stroke risk.
- Trial quality was generally poor, with small sample sizes and significant loss to follow-up.
Conclusions:
- Carotid patch angioplasty shows potential in reducing perioperative arterial occlusion and restenosis.
- Evidence suggests a reduced risk of combined death or stroke.
- A non-significant trend towards reduced all-cause mortality was observed.
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