Bovine pericardial patch angioplasty in carotid endarterectomy

Patch angioplasty during carotid endarterectomy (CEA) has been shown to red uce the incidence of both early and late complications. Controversy continu es, however, over the ideal patch material. Bovine pericardium (Vascu-Guard Biovascular Inc., Saint Paul, MN) offers an attractive alternative to othe r patch materials because of its handling and suturing characteristics that are similar to that of autogenous material. This study examines the periop erative and midterm results of bovine pericardial patch angioplasty during CEA. We studied 112 patients who underwent 129 CEAs with bovine pericardial patch angioplasty during an 18-month period. Data were collected regarding demographics, operative indications, perioperative complications, and the occurrence of late adverse outcomes based primarily on follow-up arterial d uplex studies. Among this group there were 63 male (56%) and 49 female (44% ) patients whose mean age was 71.8 +/-9.1 years. In these patients there wa s the typical distribution of atherosclerotic risk factors. Seventy-four pa tients (66%) had symptomatic disease preoperatively and the remaining 38 pa tients (34%) were asymptomatic. Temporary cranial nerve palsy occurred in t hree patients (2%). There were no perioperative strokes, acute occlusions, bleeding episodes requiring reoperation, or deaths. The patients were follo wed up to 54 months postoperatively with a mean follow-up time of 41.7 +/-4 .4 months. During this period two patients (2%) developed three significant restenoses (70-99%). All required reoperation. There were no asymptomatic occlusions, infections, aneurysms, or rupture. These data demonstrate that bovine pericardial patch angioplasty during CEA is associated with a low in cidence of both perioperative and midterm adverse outcomes.