Tag Archives: carotid endarterectomy

Carotid Angioplasty with Autologous Facial Vein

Introduction: Carotid endarterectomy (CEA) is the „gold standard” for the treatment of carotid stenosises. In this study we evaluate the results after using an alternative patch material for arteriotomy closure.
Material and methods: This study is a retrospective, observational study, in which we have compared 2 groups of 8 patients operated on in our clinic between 2008–2012, the first group of 8 patients with CEA and facial vein patch, the second group of 8 consecutive patients with CEA and PTFE patch.
Results: In the A group there were 6 males, in the B group 5 males. Group A had a median age of 60 years, group B had a median age of 60.5 years. All patients were operated for severe carotid stenosis. We evaluated the time of surgery, which varied for group A between 70 and 85 minutes, with a median of 77 minute, for group B between 75 and 100 minutes, with a median of 88 minutes. We observed a significant difference between the 2 groups regarding the time of surgery, in favour of group A (p=0.010).
Conclusions: The advantages of a autologous venous material are represented by endothelised patch, reduction of desendothelised area, higher resitance to infections. The use of facial vein for endarterectomy patch needs the same incision, elevating the cost-efficency of the procedure, and significantly reduces the operating time compared with PTFE due to a faster achievment of haemosthasis.

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Correlation Between Postoperative Cervical Haematoma in Carotid Surgery and Antiplatelet Treatment

Introduction: Cervical haematoma is one of the local complications of carotid endarterectomy. Cervical haematoma may determine oesophageal compresion or tracheal deviation. We evaluated the correlation between cervical haematoma and preoperative antiplatelet treatment.
Material and methods: We evaluated retrospectively 100 consecutive patients operated with carotid endarterectomy between 2009 and 2011. Group A of 48 patients had monoantiaggregant preoperative treatment, group B of 52 patients had dual preoperative antiaggregant treatment.
Results: We observed cervical haematomas in 16 patients from the total of 100, 13 of them being in group B. Evaluation of age, sex, surgical technique and local drainage showed no differences between the two groups. The group with monoantiaggregant preoperative treatment had a smaller chance to develop cervical haematoma (p=0.022).
Conclusions: Preoperative antiplatelet treatment is crucial for a succesful carotid endarterectomy procedure. We sustain the use of monoantiaggregant preoperative treatment, which is associated with less cervical haematomas as a local haemorrhagic complication, instead of dual antiaggregant preoperative therapy.

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