Reference : Comparison of Results of Carotid Artery Surgery after Either Direct Closure or Use of a ...

	Document type :	Scientific journals : Article
	Discipline(s) :	Human health sciences : Cardiovascular & respiratory systems Human health sciences : Surgery
	To cite this reference:	http://hdl.handle.net/2268/3880

Title :	Comparison of Results of Carotid Artery Surgery after Either Direct Closure or Use of a Vein Patch
Language :	English
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 [Centre Hospitalier Universitaire de Liège - CHU > > Chirurgie cardio-vasculaire >]
Publication date :	Jun-1997
Journal title :	Cardiovascular Surgery
Volume :	5
Issue/season :	3
Pages :	295-303
Peer reviewed :	Yes (verified by ORBi)
Audience :	International
ISSN :	0967-2109
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.
Target :	Professionals ; Students
Permalink :	http://hdl.handle.net/2268/3880

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