Primary versus patch closure after carotid endarterectomy: A retrospective study
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Nehal Farouk 1 * , Ehab M Abdo 1 , Sameh E Elimam 1 , Waleed E Elshinawy 1 , Abdelaziz A Abdelhafez 1 , Lobna Kh Sakr 2 , Walaa Husein Abdo 2 , Hayam Abdel-Tawab 3 , Eman A Elhamrawy 3 , Sahar Fares Ahmed 3 , Shymaa Adel Ismael 4 , Mahmoud Kamel Elawady 4 , Samy Ibrahim Kamel 4 , Rehab Elsheikh 5 , Ayman Osama 6
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1 Department of Vascular Surgery, Faculty of Medicine, Al-Azhar University, Cairo, EGYPT2 Department of Radiology, Faculty of Medicine, Al-Azhar University, Cairo, EGYPT3 Department of Neurology, Faculty of Medicine, Al-Azhar University, Cairo, EGYPT4 Department of Neurosurgery, Faculty of Medicine, Al-Azhar University, Cairo, EGYPT5 Department of Radiology Imaging Technology, Faculty of Applied Health Sciences, Misr University for Sciences and Technology, Cairo, EGYPT6 Department of Radiodiagnosis & Intervention, Faculty of Medicine, Helwan University, Cairo, EGYPT* Corresponding Author

Abstract

Purpose: The present study aimed to provide our experience with patch closure (PAC) and primary closure (PRC) after carotid endarterectomy (CEA).
Materials & methods: The present retrospective comparative study included 106 patients submitted to elective CEA. They comprised 50 patients in PRC group and 56 patients in PAC group. Patients were followed perioperatively, at three months and at one year for surgical complications, stroke, and restenosis.
Results: Postoperatively, no significant differences were found between the studied groups regarding rates of stroke (6.0% versus 3.6%, p=0.740), infection (0.0% versus 3.6%, p=0.520), hematoma (2.0% versus 1.8%, p=0.940), pseudoaneurysm (0.0% versus 3.6%, p=0.520), cranial nerve injury (2.0% versus 1.8%, p=0.940), and cardiac events (2.0% versus 1.8%, p=0.940). At three months, three patients in PRC group and four in PAC group were lost to follow up. No significant differences were found between the studied groups regarding rate of restenosis at three months (2.1% versus 0.0%, p=0.960). At one year, patients in PRC group experienced significantly higher rate of restenosis (14.9% versus 1.9%, p=0.046). None of the studied patients died.
Conclusions: CEA combined with patch angioplasty may be associated with lower restenosis rate.

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article Type: Original Article

ELECTRON J GEN MED, Volume 21, Issue 3, June 2024, Article No: em587

https://doi.org/10.29333/ejgm/14596

Publication date: 08 May 2024

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