1. Discretionary carotid patch angioplasty leads to good results
- Author
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Ryan Nachreiner, Michael C. Dalsing, Shoaib Shafique, Alan P. Sawchuk, Stephen G. Lalka, Dolores F. Cikrit, Connie Thornhill, and Dawn M. Larson
- Subjects
Surgical results ,Male ,medicine.medical_specialty ,Patch material ,medicine.medical_treatment ,Polyesters ,Blood Loss, Surgical ,Myocardial Infarction ,Coronary Disease ,Carotid endarterectomy ,Comorbidity ,chemistry.chemical_compound ,Blood Vessel Prosthesis Implantation ,Postoperative Complications ,Recurrence ,Angioplasty ,medicine ,Humans ,Statistical analysis ,Carotid Stenosis ,Life Tables ,Polytetrafluoroethylene ,Aged ,Retrospective Studies ,Aged, 80 and over ,Endarterectomy, Carotid ,Ultrasonography, Doppler, Duplex ,business.industry ,Patch angioplasty ,General Medicine ,Middle Aged ,Surgery ,Patch type ,Stroke ,Treatment Outcome ,chemistry ,Female ,business ,Carotid Artery, Internal - Abstract
Background This study evaluated the type and need for angioplasty in 253 consecutive carotid endarterectomies. Methods Polyester knitted gelatin sealed patch (DP) and polytetrafluoroethylene (PTFE) patches were used in, respectively, 159 and 29 patients, with 65 vessels closed primarily (no patch [NP]). Results Surgical results, estimated blood loss, and surgical time were similar in each group. Postoperative hematomas occurred in 6 DP and 3 NP patients. There were 3 strokes in the DP group. Long-term duplex evaluation was possible in 201 patients. The number of patients who had less than 15%, 15% to 50%, 50% to 79%, 80% to 99%, 100%, or an ungraded degree of narrowing were as follows for each group: DP, 117, 2, 5, 0, 1, and 2; PTFE, 18, 1, 1, 0, 0; and NP, 53, 0, 0, 0, 1. Statistical analysis failed to show any difference between groups postoperatively or in long-term follow-up evaluation. Conclusions It appears that selective patching is safe and effective in male patients who undergo carotid endarterectomy. The type of patch material also is inconsequential. Patch type and its use should be at the surgeon’s discretion.
- Published
- 2006