An evaluation of external jugular vein patch angioplasty after carotid endarterectomy

Seventy-six patients had 91 internal carotid endarterectomies closed with patch angioplasty. There were 36 redo and 55 primary procedures. External jugular vein was used as the patch material in 38, facial vein in nine, Dacron in seven, polytetra flour ethylene (PTFE) in nine, and saphenous vein in 28 operations. There were no perioperative deaths. Five patients required reoperation, but only one required replacement of a defective facial vein. There were five postoperative strokes, but two were related to a contralateral occlusion. Two of the three ipsilateral strokes had a temporary indwelling shunt. Only one patient returned with recurrent neurologic symptoms. Five other restenoses of greater than 75 per cent were noted in three patients. One false aneurysm occurred three months after an external jugular vein patch angioplasty. External jugular vein, although requiring careful handling, is conveniently located in the operative field, does not appear to be associated with increased complications, has excellent long-term results, and allows preservation of the saphenous vein for other bypass surgery.