CLINICAL-EXPERIENCE WITH EVERTED CERVICAL VEIN AS PATCH MATERIAL AFTER CAROTID ENDARTERECTOMY

Purpose: The aim of this study was to evaluate the clinical efficacy o f everted cervical veins used as patches after carotid endarterectomy. Methods: A prospective nonrandomized comparative analysis was perform ed on patients with either everted cervical veins or saphenous veins a s patches after carotid endarterectomy. Two hundred ninety-six patient s underwent 329 carotid endarterectomies during an 8 1/2-year period ( 1987 to 1995). Saphenous vein patches were used in 125 (38%) cases and everted cervical veins in 167 (51%). These two groups were compared c linically and by sonographic surveillance. The mean follow-up of patie nts in this study was 27 +/- 11 months. Results: No significant differ ences were noted regarding postoperative morbid events between the eve rted cervical and saphenous vein patch groups. Even at 5 years the per centage of patients without stroke for both groups exceeded 95%. Duple x surveillance studies also showed comparable percentages of recurrent moderate (50% to 69%) and severe (70% to 99%) stenosis, 5.6% and 6.9% , respectively, for everted cervical vein and 5.4% and 6.5%, respectiv ely, for saphenous vein. Cumulative recurrent stenosis-free rates at 5 and 6 years exceeded 82% for each of the patch study groups. Conclusi ons: Based on the results of this study everted cervical veins are use ful adjuncts to carotid endarterectomy, when patch angioplasty is nece ssary or desirable. Their performance is comparable to that of sapheno us veins. Cervical veins are usually available, even when the saphenou s vein is absent or inadequate. In addition, good saphenous veins can be spared and lower extremity excisions avoided.