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Carotid patch angioplasty: immediate and long-term results
D Rosenthal1, J P Archie, R Garcia-Rinaldi
1Georgia Baptist Medical Center, Atlanta.
Journal of Vascular Surgery
|September 1, 1990
Summary
Carotid endarterectomy closure methods, including patch angioplasty, showed no significant differences in stroke or restenosis rates. Saphenous vein patches may benefit habitual smokers and those with small carotid arteries.
Area of Science:
- Vascular Surgery
- Cardiovascular Medicine
- Surgical Outcomes Research
Background:
- Carotid endarterectomy is a procedure to remove plaque from carotid arteries.
- Various closure techniques, including primary closure and patch angioplasty, are used.
Purpose of the Study:
- To compare the effectiveness of different carotid endarterectomy closure methods.
- To evaluate the incidence of stroke, restenosis, and patency based on closure type.
Main Methods:
- Retrospective study of 1000 carotid endarterectomies.
- Patients divided into four groups: primary closure, expanded polytetrafluoroethylene patch, Dacron patch, and saphenous vein patch.
- Outcomes assessed included postoperative stroke, restenosis, and patency via B-mode ultrasonography.
Main Results:
- No statistically significant differences in postoperative stroke incidence among the four closure groups (p > 0.25).
- No significant difference in restenosis rates (greater than 50% diameter reduction) across closure methods (p > 0.25).
- Restenosis was most frequent in habitual smokers and females; saphenous vein patch showed potential benefit in these groups.
Conclusions:
- The method of carotid artery closure does not significantly impact postoperative stroke, restenosis, or late ipsilateral stroke rates.
- Patch angioplasty with saphenous vein may be advantageous for habitual smokers and patients with small internal carotid arteries.