Article (Scientific journals)
Comparison of results of carotid artery surgery after either direct closure or use of a vein patch.
Desiron, Quentin; Detry, Olivier; Van Damme, Hendrik et al.
1997In Cardiovascular Surgery, 5 (3), p. 295-303
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Keywords :
Aged; Anastomosis, Surgical/methods; Brain Damage, Chronic/etiology/mortality; Carotid Artery Thrombosis/etiology/mortality; Carotid Stenosis/mortality/surgery; Cause of Death; Endarterectomy, Carotid/methods; Female; Follow-Up Studies; Humans; Male; Postoperative Complications/etiology/mortality; Recurrence; Reoperation; Retrospective Studies; Survival Rate; Veins/transplantation
Abstract :
[en] In order to assess the benefit of vein patching versus direct closure after carotid endarterectomy, a series of 2271 carotid operations were analysed retrospectively. Apart from 114 procedures consisting of saphenous vein bypass (n = 29) and eversion endarterectomy (n = 85), 2157 open endarterectomies were performed. They were closed either directly (n = 837) or using a vein patch (n = 1320). The combined mortality-major neurological morbidity rate was 1.7%, i.e. 1% mortality (0.2% neurological) and 0.7% permanent neurological morbidity (0.5% ipsilateral to the operated artery). Early symptomatic internal carotid thrombosis was documented in six cases (four following direct closure and two after vein patching). A total of 827 carotid arteries were followed up by duplex scanning on an annual basis (244 direct closure and 583 vein patching). The mean follow-up was 44 months; 69 months for direct closure and 35 months for vein patching. In direct closure, there were 21 stenoses (9%) and 10 occult thromboses (4%); in vein patching carotids, there were 17 stenoses (3%), nine thromboses (1.8%) [corrected] and six pseudoaneurysms (1%). Annual incidence of poor results was 2.4% in direct closure, and 0.87% in vein patching. The only other factor responsible for a significant difference was gender (3.4% in women versus 2.1% in men). In this retrospective study, vein patching appears to be beneficial for the prevention of acute postoperative thrombosis and late stenosis or thrombosis.
Disciplines :
Surgery
Cardiovascular & respiratory systems
Author, co-author :
Desiron, Quentin ;  Centre Hospitalier Universitaire de Liège - CHU > Chirurgie cardio-vasculaire
Detry, Olivier  ;  Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Van Damme, Hendrik ;  Centre Hospitalier Universitaire de Liège - CHU > Chirurgie cardio-vasculaire
Creemers, Etienne ;  Centre Hospitalier Universitaire de Liège - CHU > Chirurgie cardio-vasculaire
Limet, Raymond ;  Université de Liège - ULiège > Département des sciences cliniques > Département des sciences cliniques
Language :
English
Title :
Comparison of results of carotid artery surgery after either direct closure or use of a vein patch.
Publication date :
1997
Journal title :
Cardiovascular Surgery
ISSN :
0967-2109
Publisher :
Elsevier, Exeter, United Kingdom
Volume :
5
Issue :
3
Pages :
295-303
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 07 January 2009

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