Clinical experience with everted cervical vein as patch material after carotid endarterectomy

Abstract

Based on the results of this study everted cervical veins are useful adjuncts to carotid endarterectomy, when patch angioplasty is necessary or desirable. Their performance is comparable to that of saphenous veins. Cervical veins are usually available, even when the saphenous vein is absent or inadequate. In addition, good saphenous veins can be spared and lower extremity excisions avoided.

Common Facial Vein: An Alternative Patch Material in Carotid Angioplasty

“…5 Dardik et al described cervical venous patch carotid angioplasty in 167 patients in whom they used external jugular vein in 105 and CFV in 62. 6 But the results documented in this study are those of the all procedures together with only 72 patients being followed up and the outcome of use CFValone is not known. In a retrospective study, Sabharwal and Mukherjee described the feasibility of using cervical veins in a cohort of 19 patients.…”

“…There are no reports that evaluate CFV as a patch material, although three studies have mentioned the use of CFV in heterogeneous study populations (Table 1). 5,6,14 Whereatt et al evaluated venous patch angioplasty in a cohort of 91 carotid endarterectomies where they used CFV in nine patients 5 . Dardik et al described cervical venous patch carotid angioplasty in 167 patients in whom they used external jugular vein in 105 and CFV in 62 6 .…”

“… 5,6,14 Whereatt et al evaluated venous patch angioplasty in a cohort of 91 carotid endarterectomies where they used CFV in nine patients 5 . Dardik et al described cervical venous patch carotid angioplasty in 167 patients in whom they used external jugular vein in 105 and CFV in 62 6 . But the results documented in this study are those of the all procedures together with only 72 patients being followed up and the outcome of use CFV alone is not known.…”

“…For example, patch angioplasty as an adjunct to carotid endarterectomy is believed by many surgeons to be preferable to primary closure because it may reduce the risk of early thrombosis and late recurrent stenosis and consequently the long‐term risk for ipsilateral stroke 3,4 . The patch materials that have been used are synthetic grafts, such as Dacron, polytetrafluoroethylene (PTFE) or polyurethane, and autogenous grafts, such as saphenous vein or neck vessels 5–7 . The long saphenous vein (LSV) is the most common source of autogenous tissue for venous patch angioplasty, but it is also in demand for coronary artery bypass grafting and for lower extremity revascularization for occlusive arterial disease.…”

“…3,4 The patch materials that have been used are synthetic grafts, such as Dacron, polytetrafluoroethylene (PTFE) or polyurethane, and autogenous grafts, such as saphenous vein or neck vessels. [5][6][7] The long saphenous vein (LSV) is the most common source of autogenous tissue for venous patch angioplasty, but it is also in demand for coronary artery bypass grafting and for lower extremity revascularization for occlusive arterial disease. As there is a finite amount of autogenous tissue available in patients who may be candidates for multiple vascular reconstruction procedures, we sought an alternative source of autogenous tissue in patients requiring carotid patch angioplasty.…”