Postoperative Complications of Carotid Patching: Pseudoaneurysm and Infection

Borazjani, Boris; Wilson, Samuel E.; Fujitani, Roy M.; Gordon, Ian L.; Mueller, Mark; Williams, Russell A.

doi:10.1007/s10016-001-0400-5

Cited by 57 publications

(38 citation statements)

References 15 publications

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“…Venous thromboembolism is rare among patients undergoing CEA [473][474][475] ; in ECST, the rate was 0.1%, and no cases were reported in NASCET. 377,382,437,[473][474][475][476][477][478] Wound complications are related primarily to infection (incidence Յ1%) 479,480 and hematoma (Յ5%), depending in part on perioperative antiplatelet therapy, 481 duration of surgery, perioperative use of heparin and protamine, and other factors. Prior ipsilateral CEA, contralateral laryngeal nerve palsy, and permanent tracheostomy may complicate wound management.…”

Section: Risks Associated With Carotid Endarterectomymentioning

confidence: 99%

2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease

Brott¹,

Halperin²,

Abbara

et al. 2011

Stroke

140

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Section: Risks Associated With Carotid Endarterectomymentioning

confidence: 99%

2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease

Brott¹,

Halperin²,

Abbara

et al. 2011

Stroke

140

View full text Add to dashboard Cite

“…29,30 Further, fears of patch degeneration as indicated by a higher pseudoaneurysm rate were not realized across the intermediate follow-up period represented by this series. We do not have a ready explanation for the unexpected finding of improved 30-day stroke and death rates with PC in our study.…”

Section: Discussionmentioning

confidence: 64%

Intermediate-term outcome of carotid endarterectomy with bovine pericardial patch closure compared with Dacron patch and primary closure

Nguyen

Menard

2012

Journal of Vascular Surgery

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This single-institution, retrospective review represents the largest reported experience with BPA after CEA to date and is the only report comparing outcomes after BPA to PC or to DPA. Our experience further demonstrates that patch angioplasty is protective against restenosis after CEA compared with PC. Equivalent rates of perioperative bleeding, infection, and pseudoaneurysm formation were seen with each closure strategy in this study.

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“…This inexperience with PC in concern over restenosis and ultimately has led to a preference for PAT restenosis despite the potential disadvantages of PAT such as the increased the clamp and shunt time, the risk of patch rupture, pseudoaneurysm formation, patch infection and thromboembolism from aneurismal carotid dilatation. (8,22,23) In summary, our results suggest that for experienced surgeons, PC following CEA is not necessarily inferior to PAT. PC is a safe and durable procedure and routine patching is not necessary.…”

Section: Recently the European Society For Vascular Surgery (Esvs) Gmentioning

confidence: 76%

Comparison of Outcomes between Primary Closure vs. Patch Angioplasty in Carotid Endarterectomy

et al. 2010

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Purpose: The aim of this study was to compare the short and long-term outcomes following carotid endarterectomy (CEA) with either primary closure (PC) or patch angioplasty (PAT) performed by single center vascular surgeons. Methods: Between November 1994 and March 2008, a total of 366 patients underwent 401 consecutive primary CEA procedures at our institution. We retrospectively reviewed patients' medical records. Two vascular surgeons prefer routine PC and one vascular surgeon prefer routine patch closure using bovine pericardial patch. Postoperative neurologic complications were determined by clinical neurologists. Restenosis was defined as ＞50% stenosis on follow-up duplex scan. Data was analyzed to compare the early (≤30 days) and late results of CEA between PC group and PAT group. Results: The mean follow-up duration was significantly longer in the PC group than that in the PAT group (61.7 months vs. 41.2 months, P＜0.001). Coronary artery disease and combined CEA with coronary artery bypass were more common in the PAT group (39% vs. 55%, P＜0.002; 4% vs. 12%, P＜0.004). Perioperative ipsilateral TIA/stroke rates in the PC and PAT groups were 1.5% and 0.7% (PC=4/270 vs. PAT=1/131, P=0.564). Regarding late outcomes, Kaplan-Meier analysis failed to show any difference between 2 groups on freedom from ipsilateral transient ischemic attack (TIA)/stroke, freedom from restenosis and TIA/stroke-free survival (P=0.851, P=0.232, P=0.103, log-rank test). Conclusion: Our results suggest that PC following CEA is not necessarily inferior to PAT for experienced surgeons.

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Postoperative Complications of Carotid Patching: Pseudoaneurysm and Infection

Cited by 57 publications

References 15 publications

2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease

2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease

Intermediate-term outcome of carotid endarterectomy with bovine pericardial patch closure compared with Dacron patch and primary closure

Comparison of Outcomes between Primary Closure vs. Patch Angioplasty in Carotid Endarterectomy

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