Late expulsion of a Dacron patch after carotid endarterectomy

Patch angioplasty using synthetic materials such as Dacron and polytetrafluoroethylene has become the standard of care after carotid endarterectomy. This method has been shown to reduce recurrent stenosis and stroke as compared to primary closure. Complications, including infection and pseudoaneurysm, are very rare. Another complication that has been described in two case reports to date is the late rejection of a polytetrafluoroethylene patch. We present the first reported case of a late Dacron patch expulsion 4 years after carotid endarterectomy. The patient was managed conservatively after a selective carotid arteriogram demonstrated no evidence of stenosis or pseudoaneurysm formation.