CLINICAL CASES   

Giornale Italiano di Chirurgia Vascolare 2001 March;8(1):69-76

Copyright © 2002 EDIZIONI MINERVA MEDICA

language: English, Italian

Rupture of carotid patch in bovine pericardium

Saccà A., Preda P., Curti T., Resta F., Paragona O.

From the Department of Surgical and Anesthesiological Sciences, Vascular Surgery Service * 1st Anatomy and Pathological Histology Service, Ultrastructural Diagnostics Unit Policlinico S. Orsola-Malpighi, Bologna, Italy

The ­authors ­report the ­case of a ­patient who, 20 ­months ­after ­carotid TEA ­including the appli­ca­tion of a ­bovine per­i­car­dium ­patch, pre­sented a ­swelling ­with cuta­neous ero­sion ­above the pre­vious sur­gical ­wound. The ­patch was ­removed sur­gi­cally. The ­internal ­carotid was ­replaced by ­inverted saph­e­nous ­vein and the ­external ­carotid was ­ligated. In mac­ro­scopic ­terms the ­patch pre­sented a fis­tul­ised cen­tral ero­sion on the over­lying cuta­neous ­layer. Cul­ture ­tests ­were pos­i­tive for Staph­y­lo­coccus epi­der­midis. His­to­log­ical ­tests ­showed the pres­ence of ­major hemor­rhagic phlog­osis. Ultra­struc­tural ­tests con­firmed the ­marked pres­ence of ­mixed inflam­ma­tory infil­trate, but no path­o­genic micro­or­gan­isms ­were ­observed. The ­scant ­number of ­cases in ­which ­this ­type of ­patch has ­been ­used pre­cludes any con­clu­sions ­being ­drawn ­regarding the pre­dis­po­si­tion of ­this mate­rial to infec­tion. How­ever, the com­pli­ca­tion ­described ­here con­firms the ­need for a ­closer ­follow-up of ­these ­patients.