Everted cervical vein for carotid patch angioplasty

Area of Science:

• Vascular Surgery
• Biomaterials Science

Background:

• Autologous vein grafts are theoretically beneficial for carotid endarterectomy.
• Cervical veins (facial, external jugular) were investigated as alternative patch materials.

Purpose of the Study:

• To evaluate the suitability of cervical veins as patch material after carotid endarterectomy.
• To compare the burst strength of cervical vein patches to saphenous vein patches.

Main Methods:

• A device was engineered to measure circumferential fixation and radial tension for in vivo patch burst strength.
• Bursting pressures were recorded for saphenous veins (groin and ankle) and cervical veins (single and double layer).
• Clinical outcomes of 21 carotid endarterectomies using everted cervical vein patches were reviewed.

Main Results:

• Everted (double layer) cervical vein patches showed no significant difference in burst strength compared to saphenous veins.
• Single layer cervical vein patches had significantly lower burst strength (p < 0.05).
• Clinical application in 21 patients showed one case of recurrent stenosis and one transient nerve dysfunction; one postoperative death occurred.

Conclusions:

• Everted cervical vein is a viable alternative to saphenous vein for carotid endarterectomy patch angioplasty.
• Utilizing cervical veins spares autologous saphenous vein grafts and avoids lower extremity incisions.
• Cervical vein patching yields comparable results to saphenous vein patching in this study.