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Section Editors: Geoffrey A. Donnan MD, FRACP Stephen M. Davis MD, FRACP Carotid endarterectomy has been shown to reduce the risk of stroke in selected patients with internal carotid artery stenosis. Carotid patch angioplasty performed during surgery may reduce the risk of restenosis, and consequently reduce the long-term risk of recurrent stroke. However, patching itself may be associated with complications.We tested the hypothesis that carotid patch angioplasty resulted in a lower rate of significant arterial re-stenosis and therefore fewer recurrent strokes and stroke-related deaths without an increase in perioperative complications.Two reviewers independently searched MEDLINE (1996 to April 2003), EMBASE (1980 to 2002), and Index to Scientific and Technical Proceedings (1980 to 1994). We also searched the Stroke Group trials register (April 2003), hand-searched 13 relevant journals up to 2002, …

Systematic Review of Randomized Controlled Trials of Patch Angioplasty Versus Primary Closure During Carotid Endarterectomy