Comprehensive comparison of carotid endarterectomy primary closure and patch angioplasty: A single-institution experience.

Autor:	Zagzoog N; Department of Neurosurgery, McMaster University, Hamilton, Ontario, Canada., Elgheriani A; Department of Internal Medicine, University of Manitoba, Manitoba, Canada., Attar A; Department of Neurology, McMaster University, Hamilton, Canada.; King Abdullah International Medical Research Center, Jeddeah, Saudi Arabia., Takroni R; Department of Neurosurgery, McMaster University, Hamilton, Ontario, Canada., Aljoghaiman M; Department of Neurosurgery, McMaster University, Hamilton, Ontario, Canada., Klotz L; Faculty of Medicine, University of Toronto, Toronto, Canada., Vandervelde C; Department of Internal Medicine, University of McMaster, Hamilton, Canada., Darling C; Fleming School of Nursing, Trent University, Peterborough, Ontario, Canada., Farrokhyar F; Department of Health, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada., Martyniuk A; Department of Neurosurgery, McMaster University, Hamilton, Ontario, Canada., Algird A; Department of Neurosurgery, McMaster University, Hamilton, Ontario, Canada.
Jazyk:	angličtina
Zdroj:	Surgical neurology international [Surg Neurol Int] 2022 Jan 05; Vol. 13, pp. 1. Date of Electronic Publication: 2022 Jan 05 (Print Publication: 2022).
DOI:	10.25259/SNI_1013_2021
Abstrakt:	Background: Carotid endarterectomy (CEA) is an effective intervention for the treatment of high-grade carotid stenosis. Technical preferences exist in the operative steps including the use patch for arteriotomy closure. The goals of this study are to compare the rate of postoperative complications and the rate of recurrent stenosis between patients undergoing primary versus patch closure during CEA. Methods: Retrospective chart review was conducted for patients who underwent CEA at single institution. Vascular surgeons mainly performed patch closure technique while neurosurgeons used primary closure. Patients' baseline characteristics as well as intraprocedural data, periprocedural complications, and postprocedural follow-up outcomes were captured. Results: Seven hundred and thirteen charts were included for review with mean age of 70.5 years (SD = 10.4) and males representing 64.2% of the cohort. About 49% of patients underwent primary closure while 364 (51%) patients underwent patch closure. Severe stenosis was more prevalent in patients receiving patch closure (94.5% vs. 89.4%; P = 0.013). The incidence of overall complications did not differ between the two procedures (odds ratio = 1.23, 95% confidence intervals = 0.82-1.85; P = 0.353) with the most common complications being neck hematoma, strokes, and TIA. Doppler ultrasound imaging at 6 months postoperative follow-up showed evidence of recurrent stenosis in 15.7% of the primary closure patients compared to 16% in patch closure cohort. Conclusion: Both primary closure and patch closure techniques seem to have similar risk profiles and are equally robust techniques to utilize for CEA procedures. Competing Interests: There are no conflicts of interest. (Copyright: © 2022 Surgical Neurology International.)
Databáze:	MEDLINE
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