Outcomes of carotid endarterectomy in the Vascular Quality Initiative based on patch type

Edenfield, Leia; Blazick, Elizabeth; Eldrup-Jørgensen, Jens; Healey, Christopher; Błoch, P; Hawkins, Robert E.; Aranson, Nathan J.; Nolan, Brian

doi:10.1016/j.jvs.2019.05.063

Cited by 20 publications

(23 citation statements)

References 21 publications

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“…Restenosis occurred in six (2.7%) subjects. These findings align with previous studies, which reported long-term patency rates of 79-100% with synthetic patches and 87-100% with biologic materials following carotid endarterectomy (7,11,83). There was a low rate of adverse events reported: 10 (4.5%) were reported as possibly related to the device, 1 (0.45%) was reported as probably related to the device, and 2 (0.9%) (occurring in the same patient) were reported as definitely related to the device ( Table 5).…”

Section: Sis-ecm For Carotid Artery Reconstruction-carotid Registrysupporting

confidence: 92%

“…More recently, an analysis of primary carotid endarterectomy cases recorded in the Vascular Quality Initiative (VQI) registry compared outcomes between bovine pericardium, autogenous vein, Dacron, and PTFE patches (7). At 1-year post-procedure, bovine pericardium had the lowest incidence of restenosis and was also associated with a lower incidence of return to the operating room.…”

Section: Efficacy Of Sis-ecm Patch Following Endarterectomymentioning

confidence: 99%

“…Following endarterectomy, the arteriotomy can be closed by primary repair or with a vascular patch. Based on expanding evidence of superior outcomes with patch angioplasty compared to primary repair, patch closure is currently the preferred method (7)(8)(9)(10). An ideal arterial patch must be able to withstand systemic arterial pressures over the long term, while maintaining low risk for restenosis, compliance similar to native artery, and resistance to thrombosis and/or infection (11,12).…”

Section: Introductionmentioning

confidence: 99%

“…Despite available evidence, choosing among these options remains a clinical challenge. Clinical studies have reported roughly comparable outcomes between autologous and nonautologous grafts, and between synthetic and biologic patches (7,15,16). The cost of synthetic patches are generally less than comparably-sized biologic patches, yet there are important differences between patch materials that may affect short-and long-term clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Extracellular Matrix Patches for Endarterectomy Repair

Allen

Adams

Badylak

et al. 2021

Front. Cardiovasc. Med.

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Patch repair is the preferred method for arteriotomy closure following femoral or carotid endarterectomy. Choosing among available patch options remains a clinical challenge, as current evidence suggests roughly comparable outcomes between autologous grafts and synthetic and biologic materials. Biologic patches have potential advantages over other materials, including reduced risk for infection, mitigation of an excessive foreign body response, and the potential to remodel into healthy, vascularized tissue. Here we review the use of decellularized extracellular matrix (ECM) for cardiovascular applications, particularly endarterectomy repair, and the capacity of these materials to remodel into native, site-appropriate tissues. Also presented are data from two post-market observational studies of patients undergoing iliofemoral and carotid endarterectomy patch repair as well as one histologic case report in a challenging iliofemoral endarterectomy repair, all with the use of small intestine submucosa (SIS)-ECM. In alignment with previously reported studies, high patency was maintained, and adverse event rates were comparable to previously reported rates of patch angioplasty. Histologic analysis from one case identified constructive remodeling of the SIS-ECM, consistent with the histologic characteristics of the endarterectomized vessel. These clinical and histologic results align with the biologic potential described in the academic ECM literature. To our knowledge, this is the first histologic demonstration of SIS-ECM remodeling into site-appropriate vascular tissues following endarterectomy. Together, these findings support the safety and efficacy of SIS-ECM for patch repair of femoral and carotid arteriotomy.

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Section: Sis-ecm For Carotid Artery Reconstruction-carotid Registrysupporting

confidence: 92%

Section: Efficacy Of Sis-ecm Patch Following Endarterectomymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Extracellular Matrix Patches for Endarterectomy Repair

Allen

Adams

Badylak

et al. 2021

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

“…For example, carotid endarterectomy restenosis rates have declined due to the routine use of patch angioplasty being recommended. 10 However, as mentioned previously, there was no registry for the ever-growing outpatient-based population, and the OEIS registry was created to fill this void.…”

mentioning

confidence: 99%