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Saphenous vein patch rupture after carotid endarterectomy
P J O'Hara1, N R Hertzer, L P Krajewski
1Department of Vascular Surgery, Cleveland Clinic Foundation, OH 44106.
Journal of Vascular Surgery
|March 1, 1992
Summary
Saphenous vein patch rupture is a rare complication after carotid endarterectomy. Veins harvested from the lower leg are more prone to rupture, necessitating careful selection of graft material for arteriotomy closure.
Area of Science:
- Vascular Surgery
- Surgical Complications
Background:
- Carotid endarterectomy is a common procedure to prevent stroke.
- Saphenous vein grafts are frequently used for arteriotomy closure.
Purpose of the Study:
- To investigate the incidence and characteristics of saphenous vein patch rupture after carotid endarterectomy.
- To identify risk factors associated with this complication.
Main Methods:
- Retrospective review of 2731 carotid endarterectomies performed between January 1983 and September 1990.
- Analysis of cases with saphenous vein patch rupture, focusing on patient demographics, comorbidities, and graft harvest site.
Main Results:
- Eight (0.5%) central saphenous vein patch ruptures occurred in 7 patients.
- All ruptures involved veins harvested from the leg distal to the knee.
- No ruptures were observed when veins were harvested from the groin.
- Ruptures occurred within 5 days of surgery, with 29% resulting in death or permanent neurologic deficit.
Conclusions:
- Central rupture of saphenous vein patches is a rare but serious complication.
- Vein harvested from the lower leg or ankle may have a higher risk of rupture compared to proximal thigh or groin vein.
- Judicious selection of saphenous vein harvest site is crucial for preventing this complication.