Atherosclerotic aneurysms following carotid endarterectomy with dacron patch angioplasty: An unreported complication - Three case reports

The authors report 4 atherosclerotic extracranial carotid aneurysms (AECA) in 3 patients who had carotid endarterectomies with Dacron patch angioplast y (CEADP). This complication has not previously been reported with this pat ch material in this location. These AECAs were found in a group of 204 pati ents. Two hundred thirty-two arteries (1.7%) who had CEADP and who returned for regular follow-up from 3 months to 15 years postoperatively. Three ane urysms were excised after angiographic confirmation and replaced with autol ogous saphenous vein interposition grafts uneventfully. One of the three pa tients who had bilateral CEADP has since developed a contralateral aneurysm presumed to be an AECA but has refused angiography and surgery. This aneur ysm remained essentially unchanged for two years after detection. The patie nt was then lost to follow-up. The diagnosis of AECA in the patients who we re operated on was confirmed by histology. Dacron patch angioplasty as an a djunct to carotid endarterectomy is an accepted technique which yields sati sfactory results. This report however, cautions about a significant complic ation which occurs late in the postoperative course of patients who have ha d this procedure.