PATCH ANGIOPLASTY FOLLOWING CAROTID ENDARTERECTOMY USING THE IPSILATERAL SUPERIOR THYROID ARTERY

Objectives and design: Synthetic and saphenous vein patches, when used in the carotid territory, are disadvantaged by complications. We test ed the feasibility of using a locally harvested artery, the ipsilatera l superior thyroid artery (STA), as a source of patching material foll owing carotid endarterectomy (CEA). Materials and methods: Twenty-two consecutive patients (15 male) with a median age of 70 (range 53-82) y ears under-cent CEA with art intention to use the STA for patch angiop lasty. The STA was harvested via a standard carotid incision and opene d longitudinally to fashion a patch. Results: Of the 22 STAs harvested , only two were rejected due to small calibre. Mean harvesting time wa s 12 min and there were no immediate complications. Duplex scanning ha s not revealed restenosis (mean peak velocity = 0.78 [range 0.45-1.16] m/s) in any patient with a median follow-up of 13 (range 3-19) months . Conclusions: This technique is quick, convenient and obviates many o f the disadvantages associated with conventional patches. Follow-up ha s shown the technique to be both efficacious and durable in the medium term.