The results of routine primary closure in carotid endarterectomy

Purpose of study: The aims of this study were to determine the incidence of restenosis following carotid endarterectomy with primary closure of the ar teriotomy and to observe the natural history of disease progression in the Ist postoperative year. Methods: The study group consisted of a consecutive series of 126 patients undergoing carotid endarterectomy, Duplex imaging w as performed preoperatively and at 8 weeks, 6 months and 1 year postoperati vely, Results: Five patients (4%) had a residual stenosis, At 12 months, th e overall restenosis rate was 15%: 8.5% for males and 28.9% for females. No ne of these restenoses were symptomatic. There was no significant differenc e in the diameter of the internal carotid artery between male and female pa tients (U = 896, P = 0.60) and no significant difference in the diameter of the arteries that had restenosed at 12 months and those that had remained patent (U = 391, P = 0.33). Conclusions: Carotid endarterectomy with primar y closure is associated with a low incidence of restenosis in men, but not in women. Criteria for selective patching should consider both gender and v essel calibre. (C) 1998 The International Society for Cardiovascular Surger y. Published by Elsevier Science Ltd. All rights reserved.