Bovine pericardial patch - a good alternative in femoral angioplasty.

Abstract

Bovine pericardial patch (BPP) is currently used in femoral angioplasty as an alternative for autologous vein patch (AVP), but studies comparing the results of the two methods are scarce. In this retrospective study, we aimed to discover the differences between BPP and AVP closure in long-term durability. This study consisted of all femoral endarterectomies with BPP closure performed in Helsinki University Hospital from January 1, 2014, to December 31, 2017. For comparison, the same number of consecutive patients who underwent femoral endarterectomy with AVP closure from January 1, 2014, to October 16, 2016, were reviewed. Follow-up ended December 31, 2020. The mean follow-up was 19months (range, 0-74months) in the BPP group and 22months (range, 0-79months) in the AVP group. The primary endpoint was primary patency. Secondary endpoints were restenosis at patch site detected by imaging or perioperatively, patch rupture, and deep surgical wound infection. Propensity score analysis was performed for adjustment of differences between the AVP and BPP groups. Overall primary patency was superior in the AVP group compared with the BPP group: at 1year, 96.5% vs 85.0% and at 5years, 83.0% vs 72.3% (P= .04). In propensity score-matched pairs (n= 92), no difference was found between the groups in primary patency: 95.7% and 95.7% at 1year and 92.5% and 78.6% at 5years (P= .861) or in freedom from restenosis: 100% and 100% at 1year and 89.1% and 84.0% at 5years (P= .057). Deep wound infections occurred slightly more often after BPP closure (8%) than after AVP closure (4%), but the difference was not statistically significant (P= .144). There were no patch ruptures in the BPP group, but in the AVP group, there were five ruptures (3.5%) (P= .024). BPP is compatible to AVP in femoral endarterectomy in patency and can be regarded as the safer choice considering the risk of patch rupture.