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Online ISSN 1827-1847
D’Addato M., Tealdi D. *, Curti T., Casana R. *, Cirelli M. R.
From the Department and Unit of Vascular Surgery Policlinico Sant’Orsola-Malpighi, Bologna, University of Bologna, Bologna, Italy
* Department and Unit of Vascular Surgery Hospital San Donato, Milan, University of Milan, Milan, Italy
Background. Carotid endarterectomy (CEA) remains the treatment of choice for stenosing carotid lesions to prevent stroke in symptomatic patients. A much debated subject, on which there is conflicting evidence, is the application of a widening patch as opposed to simple CEA to prevent restenosis.
Methods. From September 1994 to June 1997 we performed a prospective study on 77 patients (46 men, 31 women) who received a bovine pericardium patch (5 bilateral). History-taking disclosed TIA in 27 patients (35%) and stroke in 7 (9%); the remaining 43 patients (56%) were asymptomatic. Follow-up monitoring of 58 lasted 12 months and comprised colour Doppler ultrasonography of blood flow and arterial wall morphology.
Results. At follow-up 52 patients (67.5%) presented mild stenosis (i.e. less than 20%), four (5%) had moderate stenosis, one patient (1.3%) severe stenosis (i.e. more than 75%) requiring redo surgery, and one (1.3%) presented post-CEA ectasia controlled by colour Doppler ultrasonography. In comparison with prostheses made from synthetic polymers, such as Dacron and PTFE, bovine pericardium appears to be cheaper. This biological material also has the advantage of avoiding hemorrhage at the puncture site and is stronger than Dacron.
Conclusions. Bovine pericardium is a valid material for surgical patch application in the carotid artery.
language: English, Italian