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The Journal of Cardiovascular Surgery 2011 December;52(6):859-61

Copyright © 2011 EDIZIONI MINERVA MEDICA

lingua: Inglese

Aseptic polyurethane carotid patch rejection: complication, allergy or miraculous healing?

Tshomba Y. 1, De Dominicis D. 1, Marone E. M. 1, Mascia D. 1, Sanvito F. 2, Chiesa R. 1

1 Vascular Surgery, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy; 2 Department of Pathology, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy


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Carotid endarterectomy plays an important role in the prevention of ischemic stroke; patching could reduce the risk of intra- and postoperative complications and late restenosis among primary closure. Materials actually available for the patch tailoring are synthetic or biological: which is the best is still debated. We present the case of a polyurethane (PU) carotid patch rejection three years after its implant, with no evident arterial discontinuity and no sign of infection. Histopathological analysis on hematoxylin-eosin stained sections of the regenerated arterial wall tissue removed revealed plasma cell infiltration and clusters of foreign body giant cells. PU patch rejection has been seldom described in literature. This is an unusual late complication that should be considered at long-term follow-up evaluation of these patients.

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