Long-term follow-up of saphenous vein, internal jugular vein, and knitted dacron patches for carotid artery endarterectomy

Citation
Gr. Jacobowitz et al., Long-term follow-up of saphenous vein, internal jugular vein, and knitted dacron patches for carotid artery endarterectomy, ANN VASC S, 15(3), 2001, pp. 281-287
Citations number
28
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Surgery
Journal title
ANNALS OF VASCULAR SURGERY
ISSN journal
0890-5096 → ACNP
Volume
15
Issue
3
Year of publication
2001
Pages
281 - 287
Database
ISI
SICI code
0890-5096(200105)15:3<281:LFOSVI>2.0.ZU;2-0
Abstract
To determine whether choice of material used for patch closure following ca rotid artery endarterectomy (CAE) influences rates of early or late resteno sis, stroke, and death, 274 consecutive CAEs were retrospectively reviewed. Saphenous vein (SV) was used in 159 (58.0%) procedures; everted, double-th ickness jugular vein (JV) was used in 25 (9.1%); and knitted Dacron (KD) wa s used in 90 (32.9%). Primary closure was not used in this series. There we re four perioperative strokes: two (1.3%) in SV, one (4%) in JV, and one (1 .1%) in KD (NS). Follow-up was obtained on 263 (96%) operated arteries (mea n 41.5 months). Duplex scan results were available for 236 (89.7%) of these arteries (mean follow-up time 33.7 months). There were three (2%) late str okes in SV and two (2.2%) in KD (NS). In long-term follow-up, one patient ( 0.7%) in SV and two (2.4%) in KD developed >80% stenosis (NS). One patient (0.7%) in SV, one (5.3%) in JV, and one (1.2%) in KD had total occlusion of the operated vessel (NS). Three procedures (2.2%) in SV, 1 (5.3%) in JV, a nd 7 (8.5%) in KD demonstrated moderate stenosis (50-79%) (NS). Three-year follow-up shows that choice of patch material does not affect early or late stroke rate, stroke-related death rate, rate of high-grade (>80%) restenos is, or rate of total occlusion. There is a higher incidence of moderate ste nosis in KD. Although our results and a review of the literature do not ind icate that these patients are at increased risk for symptoms or progression of stenosis, they should be followed by duplex scanning to ensure that thi s is the case.