Carotid endarterectomy with bovine patch angioplasty: A preliminary report

Carotid endarterectomy with patch angioplasty is a durable procedure for pr evention of recurrent neurological symptoms and stroke. However, no definit ive study has demonstrated a clear benefit of one class of the patch materi al over another. The aim of this study was to evaluate the clinical outcome of carotid endarterectomy with bovine pericardium patch in comparison with autologous vein patch. One hundred and twenty-two carotid endarterectomies were performed using patch closure of the arteriotomy with bovine pericard ium (61 cases) and autologous vein (61 cases) between September 1995 and Ju ne 1999. Though this is not a double-blind type randomized comparative stud y, effort was made to achieve a 1:1 ratio in sequence with a few exceptions such as non-availabie veins at time of surgery or for future use. In bovin e pericardium patch closure group, the mean total operating time was signif icantly shorter than autologous vein closure group (P <0.01), but the mean carotid clamping time was similar in both groups, regardless of the use of shunt. The incidence of postoperative local complications including groin w ound was less in bovine pericardium patch closure group. The patients were followed with duplex scans in one month post-CEA and 6 months interval ther eafter. During the follow-up period, three patients developed non-critical stenosis (two in bovine and one in vein patch), and one aneurysmal dilation occurred in vein patch group. The incidence of restenosis was similar in b oth groups. Although this is a preliminary report, it is concluded that the results of carotid angioplasty using bovine pericardium compare favorably with autologous vein. (C) 2001 The International Society for Cardiovascular Surgery. Published by Elsevier Science Ltd. All rights reserved.