Open AccessSequential cohort study of Dacron ® patch closure following carotid endarterectomy
Author(s) -
Ali T.,
Sabharwal T.,
Dourado R. A.,
Padayachee T. S.,
Hunt T.,
Burnand K. G.
Publication year - 2005
Publication title -
british journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.202
H-Index - 201
eISSN - 1365-2168
pISSN - 0007-1323
DOI - 10.1002/bjs.4808
Subject(s) - arteriotomy , medicine , carotid endarterectomy , stroke (engine) , stenosis , perioperative , surgery , endarterectomy , angiography , computed tomography angiography , radiology , cardiology , artery , mechanical engineering , engineering
Background: Carotid endarterectomy reduces the risk of stroke and death in patients with severe carotid artery stenosis. This study examined whether the technique used to close the arteriotomy influenced the rate of perioperative transient ischaemic attack (TIA), stroke or death. Methods: A cohort of 236 patients undergoing carotid endarterectomy at a single centre was studied; 117 patients had primary closure of the arteriotomy and 119 patients in a sequential series had closure with a Dacron ® patch. A standard endarterectomy with completion intraoperative duplex imaging and digital subtraction angiography was used throughout. Results: Patch closure was associated with a significant reduction in the 30‐day combined death, stroke and TIA rate: 10·3 per cent for primary closure versus 2·5 per cent for patch closure ( P = 0·017). The risk of any cerebral event (stroke or TIA) was also significantly reduced (7·7 versus 1·7 per cent; P = 0·033). Residual stenosis on completion angiography was more common after primary closure (24·6 versus 7·4 per cent; P = 0·003). Conclusion: Dacron ® patch closure had a higher technical success rate on completion imaging and was associated with a significant reduction in the risk of perioperative stroke, TIA and death. Copyright © 2005 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.