| Does routine patch angioplasty after carotid endarterectomy lessen the risk of perioperative stroke? | |
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MedLine Citation:
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PMID: 8268069 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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From 1964 through 1991 we performed primary closure of the arteriotomy in 1173 patients and patch angioplasty in 506 patients after carotid endarterectomy. The decision to patch was made at the surgeon's discretion. In general a patch was used for small arteries. In the primary closure group 32 patients (2.7%) had a perioperative stroke and in the patch angioplasty group 17 (3.4%) had a stroke. The difference (2.7% vs. 3.4%) was not significant (p < 0.5275, Fisher's exact two-tailed test). A total of 240 arteries were closed with a vein patch and 11 (4.6%) of these patients had a stroke; 266 were closed with a synthetic patch (Dacron, 211; polytetrafluoroethylene, 55) and six of the patients had a stroke (2.3%). The difference in stroke rate between the vein and synthetic patch groups (4.6% vs. 2.3%) was not significant (p < 0.2159). Patch angioplasty cannot be shown to reduce the incidence of perioperative stroke. Late carotid patency was not studied. This study supports a policy of selective patch angioplasty based on arterial size rather than patching all carotid arteries. When a patch is used, we prefer filamentous Dacron as the patch material. |
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Authors:
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R L Treiman; R F Foran; W H Wagner; D V Cossman; P M Levin; J L Cohen |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Annals of vascular surgery Volume: 7 ISSN: 0890-5096 ISO Abbreviation: Ann Vasc Surg Publication Date: 1993 Jul |
Date Detail:
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Created Date: 1994-01-31 Completed Date: 1994-01-31 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8703941 Medline TA: Ann Vasc Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 317-9 Citation Subset: IM |
Affiliation:
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Cedars Sinai Medical Center, Los Angeles, Calif. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Angioplasty Carotid Arteries / surgery* Carotid Artery Thrombosis / etiology Cause of Death Cerebrovascular Disorders / etiology, prevention & control* Endarterectomy, Carotid / adverse effects, methods* Equipment Design Female Humans Ischemic Attack, Transient / etiology Male Middle Aged Polyethylene Terephthalates Polytetrafluoroethylene Prostheses and Implants* Risk Factors Saphenous Vein / transplantation* Vascular Patency |
| Chemical | |
Reg. No./Substance:
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0/Polyethylene Terephthalates; 9002-84-0/Polytetrafluoroethylene |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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