Saphenous vein patch versus polytetrafluoroethylene patch after carotid endarterectomy

Area of Science:

• Vascular Surgery
• Cardiovascular Research

Background:

• Carotid endarterectomy is a common procedure to prevent stroke.
• The choice of patch material for carotid patch angioplasty remains debated.

Purpose of the Study:

• To prospectively evaluate the risks and benefits of saphenous vein patch versus PTFE patch in carotid endarterectomy.

Main Methods:

• A 4-year prospective randomized trial comparing saphenous vein (n=40) and PTFE (n=44) patches in 95 carotid endarterectomies.
• Patients were assessed post-operatively and at long-term follow-up using Doppler, photoplethysmography, angiography, and neurologic exams.

Main Results:

• PTFE patch procedures took longer due to bleeding.
• The PTFE group experienced one stroke and one death from arterial disruption, while the venous patch group had no perioperative complications.
• Aneurysmal dilatation was higher in the venous patch group (15.5%) compared to PTFE (2%).
• Recurrent stenosis occurred in two PTFE cases, requiring one reoperation. One PTFE patient developed an infected false aneurysm.

Conclusions:

• Saphenous vein patches demonstrated a better safety profile regarding major perioperative complications like stroke and death.
• PTFE patches were associated with a lower incidence of aneurysmal dilatation but higher rates of recurrent stenosis and infection.