Comparison of primary suturing and dacron patch in carotid endarterectomy

Abstract

Background: In carotid artery atherosclerotic disease; indications for intervention are accepted to be over 75% stenosis for asymptomatic patients and over 50% for symptomatic patients. Preferred surgical treatment is carotid endarterectomy. In this study, we compared clinical outcomes and ultrasonographic findings in two different surgical techniques of arteriotomy closure. First technique consisted of primary suturing and second is patch angioplasty with dacron patch. In 6 month follow up period clinical examinations and dupplex ultrasonography were performed and analysed statistically. 
 Methods: 60 patients who underwent carotid endarterectomy for carotid artery disease between January 2017 and December 2020 were enrolled in the study. Data was obtained from hospital database and evaluated statistically. 30 arteriotomy incisions were closed primarily and 30 with dacron patch angioplasty. As surgical indication 50% stenosis in symptomatic patients and 70% stenosis in asymptomatic were determined. Postoperative complications were evaluated. After discharge one-week, two-month, six-month clinical examitanions were performed and in six-month follow up dupplex ultrasonography was performed by an independent radiology specialist, and these results were compared statistically. 
 Results: When the patients were evaluated in terms of postoperative complications, clinical follow-up after discharge, and 6-month Doppler ultrasonography, no significant differences were detected.
 Conclusion: No statistically significant difference was found among techniques primary suturing and dacron patch angioplasty for stroke, occlusion and re-stenosis rates. According to short term results both techniques may be feasible for arteriotomy closure during carotid endarterectomy.