Document Detail


Saphenous vein patch versus polytetrafluoroethylene patch after carotid endarterectomy.
MedLine Citation:
PMID:  7698967     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Although carotid patch angioplasty has been performed on a selective or routine basis in all large series of carotid endarterectomy, the choice of patch material still remains in question. The objective of this study has been a prospective randomized evaluation of the relative risks and benefits of saphenous vein patch versus PTFE patch material for carotid endarterectomy. During a 4-year period, 84 patients undergoing 95 carotid endarterectomies were randomized into two groups: 45 venous patch (n = 40) and 50 PTFE patch (n = 44). All operations were carried out under general anesthesia and systematic placement of a shunt. The patients were evaluated at 1, 3, 6 months and every year with doppler, periorbitary photoplethysmography, intravenous digital subtraction angiography, and neurologic assessment (mean follow-up 29 +/- 1 month). Operative time among patients having PTFE patch was significantly longer (p < 0.05) than among those having saphenous vein patch, due to bleeding from suture holes. Perioperatively, no neurologic complications or deaths were observed in venous patch patients, however there was a permanent stroke and one death from arterial wall disruption in the PTFE patch group. The incidence of aneurysmal dilatation in the saphenous vein patch group (15.5%) was higher than for the PTFE patch group (2%). On late follow-up, no deaths, carotid thrombosis or patch rupture were observed in either group. Recurrent stenosis occurred in 2 cases having PTFE patch. One reoperation for recurrence was required. In addition, one patient with PTFE patch angioplasty developed an infected false aneurysm at 7 months.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
J A González-Fajardo; J L Pérez; A M Mateo
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Journal of cardiovascular surgery     Volume:  35     ISSN:  0021-9509     ISO Abbreviation:  J Cardiovasc Surg (Torino)     Publication Date:  1994 Dec 
Date Detail:
Created Date:  1995-05-04     Completed Date:  1995-05-04     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0066127     Medline TA:  J Cardiovasc Surg (Torino)     Country:  ITALY    
Other Details:
Languages:  eng     Pagination:  523-8     Citation Subset:  IM    
Affiliation:
Department of Surgery, Hospital Universitario of Valladolid, Spain.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty / methods*
Carotid Stenosis / epidemiology,  surgery*
Cerebrovascular Disorders / epidemiology
Endarterectomy, Carotid / methods*
Female
Follow-Up Studies
Humans
Male
Polytetrafluoroethylene*
Postoperative Complications / epidemiology
Prospective Studies
Risk Factors
Saphenous Vein / transplantation*
Time Factors
Chemical
Reg. No./Substance:
9002-84-0/Polytetrafluoroethylene

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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