John C Papakostas1, Stavros Avgos1, Eleni Arnaoutoglou2, Christos Nassis3, Michalis Peroulis1, Christina Bali1, George Papadopoulos2, Miltiadis I Matsagkas4. 1. Department of Surgery-Vascular Surgery Unit, Medical School, University of Ioannina, Ioannina, Greece. 2. Department of Anesthesiology, Medical School, University of Ioannina, Ioannina, Greece. 3. Department of Neurology, Medical School, University of Ioannina, Ioannina, Greece. 4. Department of Surgery-Vascular Surgery Unit, Medical School, University of Ioannina, Ioannina, Greece. Electronic address: milmats@gmail.com.
Abstract
BACKGROUND: To report the early and long-term results of Vascu-Guard bovine pericardium (BP) for patch angioplasty in carotid endarterectomy (CEA). METHODS: We retrospectively analyzed the data of 256 CEAs with BP patch closure performed in 238 patients during the past 12 years in our department. Patch-related complications (restenosis, infection, and aneurysm formation) and early and late (12 to 144 months follow-up) clinical outcomes were recorded and statistically analyzed. RESULTS: Thirty-day postoperative stroke rate was 1.2% (3/256) with zero mortality. Major complications occurred in 3.5% (9 of 256) of the procedures and cranial nerve injury in 4.3% (11 of 256). At 12 years, cumulative estimates of freedom from any stroke, stroke-free survival, and freedom from restenosis were 88.4% (standard error [SE]: 3.3%), 60% (SE: 7.8%), and 98.3% (SE: 0.8%), respectively. No patient experienced patch infection or aneurysm formation. CONCLUSIONS: This series shows the efficacy, safety, and durability of CEA with BP patch closure, in both the short and long term. BP combines the advantages of vein and synthetic patches, representing a suitable option when performing CEA.
BACKGROUND: To report the early and long-term results of Vascu-Guard bovine pericardium (BP) for patch angioplasty in carotid endarterectomy (CEA). METHODS: We retrospectively analyzed the data of 256 CEAs with BP patch closure performed in 238 patients during the past 12 years in our department. Patch-related complications (restenosis, infection, and aneurysm formation) and early and late (12 to 144 months follow-up) clinical outcomes were recorded and statistically analyzed. RESULTS: Thirty-day postoperative stroke rate was 1.2% (3/256) with zero mortality. Major complications occurred in 3.5% (9 of 256) of the procedures and cranial nerve injury in 4.3% (11 of 256). At 12 years, cumulative estimates of freedom from any stroke, stroke-free survival, and freedom from restenosis were 88.4% (standard error [SE]: 3.3%), 60% (SE: 7.8%), and 98.3% (SE: 0.8%), respectively. No patient experienced patch infection or aneurysm formation. CONCLUSIONS: This series shows the efficacy, safety, and durability of CEA with BP patch closure, in both the short and long term. BP combines the advantages of vein and synthetic patches, representing a suitable option when performing CEA.
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