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A Rat Carotid Artery Pressure-Controlled Segmental Balloon Injury with Periadventitial Therapeutic Application
Published on: July 9, 2020
Patch angioplasty versus primary closure for carotid endarterectomy
Kittipan Rerkasem1, Peter M Rothwell
1Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand, 50200.
The Cochrane Database of Systematic Reviews
|October 13, 2009
Summary
Carotid patch angioplasty may reduce the risk of stroke and restenosis after carotid endarterectomy. This updated review confirms its benefits, though trial quality varies.
Area of Science:
- Vascular Surgery
- Neurology
- Cardiovascular Medicine
Background:
- Carotid endarterectomy is a procedure to remove plaque from carotid arteries.
- Patch angioplasty, using venous or synthetic material, is an alternative to primary closure after endarterectomy.
- This review updates previous analyses on patch angioplasty's role in preventing stroke and restenosis.
Purpose of the Study:
- To evaluate the safety and efficacy of carotid patch angioplasty versus primary closure.
- To compare routine or selective patch angioplasty against primary closure in carotid endarterectomy.
Main Methods:
- Systematic review and meta-analysis of randomized and quasi-randomized controlled trials.
- Searched multiple databases (Cochrane, MEDLINE, EMBASE) up to November 2008.
- Included 10 trials with 1967 patients; data assessed by two independent reviewers.
Main Results:
- Carotid patch angioplasty significantly reduced ipsilateral stroke risk (perioperative and long-term).
- Patch angioplasty decreased perioperative arterial occlusion and long-term restenosis rates.
- Few arterial complications were noted for either method; no significant difference in all-cause mortality.
Conclusions:
- Limited evidence suggests carotid patch angioplasty reduces perioperative occlusion and restenosis.
- Patch angioplasty appears to lower ipsilateral stroke risk.
- A non-significant trend suggests reduced perioperative stroke and all-cause mortality.
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