DOES THE CHOICE OF MATERIAL INFLUENCE EARLY MORBIDITY IN PATIENTS UNDERGOING CAROTID PATCH ANGIOPLASTY

Background. This study was undertaken to determine whether the choice of material influences the early morbidity of patients undergoing caro tid patch angioplasty. Methods. Before undergoing carotid endarterecto my, 190 patients were randomized to receive 207 patch closures with ei ther Dacron (USCI Sauvage knitted velour) or saphenous vein harvested from the thigh. Results. One hundred seven Dacron and 100 vein patch a ngioplasties were performed. No significant difference was seen betwee n the two groups in patient age, sex, preoperative risk factors, or in dication for operation (p > 0.25 for each variable). Among the patient s undergoing Dacron patch angioplasty three strokes (two temporary and one permanent), seven episodes of bleeding requiring reoperation, and two neck wound infections requiring rehospitalization occurred. The f inal 32 patients with Dacron patch closures had their anticoagulation reversed and had no bleeding complications. Complications in patients undergoing vein patch closure included one fatal perioperative stroke, two episodes of bleeding requiring reoperation including one patch ru pture, and three groin infections requiring hospitalization. No signif icant difference was seen between the two groups in the rate of periop erative stroke (p = 0.62), episodes of bleeding (p = 0.17), or infecti on (p => 0.67). Conclusions. Carotid patch angioplasty can be performe d with an acceptably low complication rate with either Dacron or vein, and the choice of patch material does not clinically affect patient m orbidity. However, reversal of anticoagulation is recommended to minim ize bleeding complications in patients undergoing Dacron patch angiopl asty.