Abstract
Patch angioplasty has been used in carotid endarterectomy (CEA) to protect against early occlusion and restenosis of the internal carotid artery (ICA). We evaluated early surgical results of CEA and restenosis using 3 materials for patch angioplasty: Hemashield, expanded polytetrafluoroethylene (PTFE) and saphenous vein, which were used in 5, 12 and 10 CEAs, respectively (randomized control). Irrespective of the material used in CEA, the operative time and blood loss were not significantly different. We found it difficult to pass the needle through the PTFE and the Hemashield; bleeding from the needle hole was seen with the PTFE. The vein patch was easy to handle. There were no perioperative deaths. One patient in the Hemashield group manifested TIA. Two patients in the saphenous vein graft group had a subcutaneous hematoma in the thigh, the location of the vein harvest. There was no permanent or life-threatening complications in any of the patients undergoing CEA, nor were there restenosis or aneurysm formation in the ICA after CEA, irrespective of the material used for patch angioplasty. Consequently, all 3 of the materials appear to be safe for use. Long-term follow-up will identify the material best suited for patch angioplasty.
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