| Carotid Endarterectomy with Primary Closure: Analysis of Outcomes and Review of the Literature. | |
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MedLine Citation:
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PMID: 21904262 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND:: Despite abundant published support of patch angioplasty during carotid endarterectomy(CEA), primary-closure is still widely used. The reasons underlying the persistence of primary closure are not quite evident in the literature. OBJECTIVE:: To present our experience with primary closure in CEA, and provide a rationale for its persistent wide use. METHODS:: Medical records of all patients undergoing CEA by the senior author (RF) were retrospectively reviewed. Follow-up was supplemented with a telephone-interview and completion of a structured questionnaire. A review of the current literature was performed. RESULTS:: From 1998 to 2010, the senior author performed 111 CEAs. Average cross-clamp time was 33±11min. Postoperative complications included 1 non-ST-elevation myocardial infarction and two strokes. No deaths, cranial-nerve deficits, or acute re-occlusions were observed. After a mean follow-up of 64.6 months (7,170.6 case-months), there were 3 contralateral strokes and7 deaths. There were no ipsilateral strokes or restenoses >50%.Follow-up medication compliance was 94.6% for antiplatelet agents and 91.9% for statins. The outcomes of the current study were comparable to those of the available trials comparing patch angioplasty with primary closure. A careful evaluation of the literature revealed a number of reasons potentially explaining the persistent use of patch angioplasty. CONCLUSION:: In conjunction with contemporary medical management, primary closure during CEA may yield results comparable or superior to patch angioplasty. Advantages of primary closure include shorter cross-clamp times and elimination of graft-specific complications. |
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Authors:
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Georgios Zenonos; Ning Lin; Albert Kim; Jeong Eun Kim; Lance Governale; Robert Max Friedlander |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-9-01 |
Journal Detail:
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Title: Neurosurgery Volume: - ISSN: 1524-4040 ISO Abbreviation: - Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-9-9 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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1Department of Neurological Surgery, University of Pittsburgh Medical Center; 2Department of Neurological Surgery, Brigham and Women's Hospital, Harvard Medical School; 3Department of Neurological Surgery, University of Miami School of Medicine. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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