Venous patches Patching with autologous venous tissue remains the most commonly used option for arterial patching during CEA, and continues to show superb results in the literature Table 3. Biomaterial patches Bovine pericardium has served for many years as a popular option as a biomaterial patch for CEA. Future directions As excellent results are currently being obtained with available patch materials, directions for future development may lie in the prevention of unusual complications such as infection and pseudoaneurysm.
Conclusion Although minimally invasive carotid artery angioplasty and stenting preoccupies much discussion in the treatment of carotid artery stenosis, the majority of patients with carotid disease are still treated by open surgery. Footnotes Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication.
References 1. Reconstruction of internal carotid artery in a patient with intermittent attacks of hemiplegia. Hospital volume and surgical mortality in the United States. N Engl J Med. Trends complications, and mortality in peripheral vascular surgery. Heart disease and stroke statistics update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee.
Imparato AM. The role of patch angioplasty after carotid endarterectomy. A systematic review of the randomised trials of carotid patch angioplasty in carotid endarterectomy. Eur J Vasc Endovasc Surg. A clinical comparison of Dacron patch closure of small-caliber carotids compared with primary closure of large-caliber carotids after endarterectomy.
Am Surg. Patch angioplasty versus primary closure for carotid endarterectomy. Cochrane Database Syst Rev. Carotid artery patch angioplasty: impact and outcome. Ann Vasc Surg. Systematic review of randomized controlled trials of patch angioplasty versus primary closure and different types of patch materials during carotid endarterectomy. Temporal profile of the healing process and effects of anticoagulation therapy. J Neurosurg. Semin Vasc Surg. Multistate utilization, processes, and outcomes of carotid endarterectomy.
Improved outcomes of carotid endarterectomy: the critical role of vascular surgeons. US Patent - Blood vessel patch. Issued on March 31, The rationale for patch-graft angioplasty after carotid endarterectomy: early and long-term follow-up. Prospective randomized trial of carotid endarterectomy with primary closure and patch angioplasty with saphenous vein, jugular vein, and polytetrafluoroethylene: long-term follow-up.
A prospective randomized study of saphenous vein patching versus synthetic patching during carotid endarterectomy. Randomized trial of vein versus dacron patching during carotid endarterectomy: long-term results. Patches of different types for carotid patch angioplasty. Prospective randomized study of carotid endarterectomy with polytetrafluoroethylene versus collagen-impregnated Dacron Hemashield patching: perioperative day results.
Postoperative complications of carotid patching: pseudoaneurysm and infection. Krishnan S, Clowes AW. Dacron patch infection after carotid endarterectomy: case report and review of the literature.
Infected postcarotid endarterectomy pseudoaneurysms: retrospective review of a series. Use of muscle flap to cover infections of the carotid artery after carotid endarterectomy.
Influence of vein-patch angioplasty on carotid endarterectomy healing. Arch Surg. Long-term follow-up of saphenous vein, internal jugular vein, and knitted Dacron patches for carotid artery endarterectomy. Clinicopathologic correlation in postendarterectomy recurrent stenosis.
A case report and bibliographic review. Rupture of the vein patch: a rare complication of carotid endarterectomy. Blowout of carotid venous patch angioplasty. Carotid endarterectomy complicated by vein patch rupture.
Saphenous vein patch rupture after carotid endarterectomy. Vein-patch rupture after carotid endarterectomy: an avoidable catastrophe. Br J Surg. Archie JP. Carotid endarterectomy saphenous vein patch rupture revisited: Selective use on the basis of vein diameter. J Vasc Surg Everted cervical vein for carotid patch angioplasty.
Clinical experience with everted cervical vein as patch material after carotid endarterectomy. Carotid endarterectomy with homologous vein patch angioplasty: a review of cases. Thompson JE. Complications of carotid endarterectomy and their prevention. World J Surg. Infected false aneurysm following carotid endarterectomy with vein patch angioplasty. J Cardiovasc Surg. Complications resulting from saphenous vein patch graft after carotid endarterectomy. Carotid endarterectomy with bovine pericardium patch angioplasty: mid-term results.
Results of carotid endarterectomy with pericardial patch angioplasty: rate and predictors of restenosis. Carotid endarterectomy with bovine patch angioplasty: a preliminary report. Cardiovasc Surg. Neuhauser B, Oldenburg WA. Polyester vs. Bovine pericardium vs dacron for patch angioplasty after carotid endarterectomy: a prospective randomized study. David TE. The surgical treatment of patients with prosthetic valve endocarditis.
By using a proximal segment of the right internal mammary artery as patch material, we assumed that this would minimize the risk of restenosis of the LMCA. We here review our experience and results. Follow-up at a mean of 45 months range, 7 to 79 included a stress test, echocardiography, and angiography with intravascular ultrasound IVUS of the LMCA. Most people who have angioplasty also have a stent placed in their blocked artery during the same procedure.
A stent, which looks like a tiny coil of wire mesh, supports the walls of your artery and helps prevent it from re-narrowing after angioplasty. Most stents implanted during an angioplasty are drug coated. The medication in the stent is slowly released to help prevent future plaque buildup and the re-narrowing of the blood vessel. After your stent placement, your doctor will prescribe medications, such as aspirin, clopidogrel Plavix , ticagrelor Brilinta or prasugrel Effient , to reduce the chance of blood clots forming on the stent.
If you had a nonemergency procedure, you'll probably remain at the hospital overnight while your heart is monitored and your medications are adjusted.
You generally should be able to return to work or your normal routine the week after angioplasty. When you return home, drink plenty of fluids to help flush your body of the contrast dye. Avoid strenuous exercise and lifting heavy objects for at least a day afterward.
Ask your doctor or nurse about other restrictions in activity. It's important that you closely follow your doctor's recommendations about your treatment with blood-thinning medications — aspirin and clopidogrel Plavix , prasugrel Effient or similar medications.
Most people who have undergone angioplasty with or without stent placement will need to take aspirin indefinitely. Those who have had stent placement will need a blood-thinning medication, such as clopidogrel, for six months to a year.
If you have any questions or if you need any other type of surgery, talk to your cardiologist before stopping any of these medications. Coronary angioplasty greatly increases blood flow through the previously narrowed or blocked coronary artery. Chest pain generally should decrease. You may be better able to exercise. Having angioplasty and stenting doesn't mean your heart disease goes away.
You'll need to continue healthy lifestyle habits and take medications as prescribed by your doctor. If you have symptoms similar to those you had before coronary angioplasty, such as chest pain or shortness of breath, contact your doctor.
If you have chest pain at rest or pain that doesn't respond to nitroglycerin, call or emergency medical help. Successful angioplasty also means you might not have to undergo coronary artery bypass surgery, a more invasive procedure that requires a longer recovery time.
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Advertising revenue supports our not-for-profit mission. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. This content does not have an English version. This content does not have an Arabic version. Overview Coronary angioplasty AN-jee-o-plas-tee , also called percutaneous coronary intervention, is a procedure used to open clogged heart arteries.
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