Short- and Long-Term Outcomes Following Biological Pericardium Patches Versus Prosthetic Patches for Carotid Endarterectomy: A Retrospective Bicentric Study

Autor: Branchereau Pascal, Marty-Ané Charles Henri, Faure Elsa, Alric Pierre, Peyre-Costa David, Picard Eric, Canaud Ludovic, Freycon-Tardy Léonore
Přispěvatelé: Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)
Rok vydání: 2021
Předmět:
Carotid Artery Diseases
Male
Time Factors
[SDV]Life Sciences [q-bio]
medicine.medical_treatment
Carotid endarterectomy
030204 cardiovascular system & hematology
030218 nuclear medicine & medical imaging
0302 clinical medicine
Restenosis
Recurrence
Risk Factors
Interquartile range
Stroke
ComputingMilieux_MISCELLANEOUS
Aged
80 and over
Endarterectomy
Carotid
Univariate analysis
General Medicine
Middle Aged
3. Good health
Treatment Outcome
Heterografts
Female
France
medicine.symptom
Cardiology and Cardiovascular Medicine
Pericardium
medicine.medical_specialty
Prosthesis-Related Infections
Postoperative Hemorrhage
Risk Assessment
Asymptomatic
Blood Vessel Prosthesis Implantation
03 medical and health sciences
Angioplasty
medicine
Animals
Humans
Aged
Retrospective Studies
business.industry
Ultrasonography
Doppler
medicine.disease
Blood Vessel Prosthesis
Surgery
Stenosis
Cattle
business
Zdroj: Annals of Vascular Surgery
Annals of Vascular Surgery, Elsevier Masson, 2020, ⟨10.1016/j.avsg.2020.04.010⟩
ISSN: 0890-5096
1615-5947
DOI: 10.1016/j.avsg.2020.04.010
Popis: Background Currently, there are various types of patches available on the market for carotid endarterectomy (CEA) with enlargement angioplasty, prosthetic, and biological patches including bovine pericardial patches. Despite the increasing use of these biological patches, there are little data in the literature comparing the results of these 2 types of patch. The purpose of this study is to compare the short- and long-term results of bovine pericardium patches (BPPs) with prosthetic patches (PPs) in carotid thromboendarterectomy. Methods This study presents a retrospective analysis of all CEAs performed at Montpellier and Nimes University Hospitals (France) in 2014 and 2015. Patients who underwent eversion were excluded. Preoperative, peroperative, and postoperative clinical and Doppler ultrasound results were collected and analyzed. The primary end point was the comparison of the restenosis rate between the BPP and the PP group. Secondary end points were the analysis of restenosis risk factors (type of patch, gender, renal failure, smoking, diabetes, arterial hypertension, dyslipidemia, and redo surgery were analyzed); the comparison of morbidity–mortality and infection between the BPP and the PP group and the comparison of morbidity–mortality between symptomatic and asymptomatic stenosis. Results In total, 342 CEAs were performed: 168 (49%) with BPP and 174 (51%) with PP. Median follow-up was 30 months (interquartile range = 24). The stroke rate at day 30 was 3.22% and mortality at day 30 was 1.86%. There was no significant difference between groups concerning anyone of the variables of interest. At the end of follow-up, the restenosis rate >50% was 7.31% (6.45% for the BPP group vs. 8.22% for the PP group, P = 0.55). The severe restenosis rate (>70%) was 4.65% (5.16% for the BPP group vs. 4.11% for the PP group, P = 0.79). The univariate analysis identified renal failure (odds ratio = 2.69) as the main risk factor. The postoperative infection rate was 1.17% (0.59% for the BPP group vs. 1.75% for the PP group, P = 0.62). Conclusions The rates of stroke and postoperative death, bleeding, infection, and restenosis are comparable between BPPs and PPs in our study. The use of prosthetic or biological patches seems to deliver comparable outcomes. Further studies on larger samples are required.
Databáze: OpenAIRE
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