Comparison of Outcomes between Primary Closure vs. Patch Angioplasty in Carotid Endarterectomy.
10.4174/jkss.2010.78.5.314
- Author:
Woo Sung YUN
1
;
Dong Ik KIM
;
Kyung Bok LEE
;
Ui Jun PARK
;
Young Wook KIM
;
Gyeong Moon KIM
;
Chin Sang CHUNG
;
Oh Young BANG
;
Keon Ha KIM
Author Information
1. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. dikim@skku.edu
- Publication Type:Original Article
- Keywords:
Carotid endarterectomy;
Primary closure;
Patch anigoplasty
- MeSH:
Angioplasty;
Constriction, Pathologic;
Coronary Artery Bypass;
Coronary Artery Disease;
Endarterectomy, Carotid;
Follow-Up Studies;
Freedom;
Humans;
Ischemic Attack, Transient;
Kaplan-Meier Estimate;
Medical Records;
Retrospective Studies
- From:Journal of the Korean Surgical Society
2010;78(5):314-319
- CountryRepublic of Korea
- Language:English
-
Abstract:
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 (< or =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.
