Department of Cardiovascular Surgery, Afyonkarahisar Health Sciences University Hospital, Afyonkarahisar, Turkey.
Braz J Cardiovasc Surg. 2022 Dec 1;37(6):37-6. doi: 10.21470/1678-9741-2020-0716.
The aim of our study was to compare the primary closure (PRC) and patch angioplasty closure (PAC) of carotid artery following carotid endarterectomy (CEA).
Data of patients who underwent CEA in the period from January 2005 to June 2020 were reviewed through files. Demographic characteristics, information about the operation, and postoperative follow-up outcomes of the patients were compared.
Of the 144 CEA cases included in the study, PRC and PAC were applied to 62 (43.7%) and 82 (56.3%) patients, respectively, for the carotid artery closure. Duration of surgery and carotid artery clamping time were not different between the PRC and PAC groups (106.73±17.13 minutes vs. 110.48±20.67 minutes, P=0.635; 24.25±11.56 minutes vs. 25.19±8.99 minutes, P=0.351, respectively). Postoperative respiratory impairment was more common in the PRC group (P=0.012); however, nerve injuries (P=0.254), surgical wound hematomas (P=0.605), surgical site infections (P=0.679), and mortality (P=0.812) were not significantly different between the groups. During the mean patient follow-up time of 26.13±19.32 months, restenosis was more common in the PRC group than in the PAC group (n=26, 41.9% vs. n=4, 4.9%, respectively; P=0.003). Frequencies of stroke (n=4, 2.8% vs. n=2, 2.4%, respectively; P=0.679), transient ischemic attacks (n=2, 1.4% vs. n=0, 0%, respectively; P=0.431), and mortality (n=4, 6.5% vs. n=4, 4.9%, respectively; P=0.580) were not significantly different between the PRC and PAC groups.
We are of the opinion that the PAC method is effective and safe for carotid artery closure in patients undergoing CEA.
本研究旨在比较颈动脉内膜切除术（CEA）后采用颈动脉直接缝合（PRC）与补片血管成形术（PAC）进行颈动脉关闭的效果。
通过病历回顾 2005 年 1 月至 2020 年 6 月期间接受 CEA 的患者资料。比较患者的人口统计学特征、手术信息和术后随访结果。
在纳入的 144 例 CEA 病例中，62 例（43.7%）和 82 例（56.3%）患者分别采用 PRC 和 PAC 进行颈动脉关闭。PRC 组和 PAC 组的手术时间和颈动脉夹闭时间无差异（106.73±17.13 分钟 vs. 110.48±20.67 分钟，P=0.635；24.25±11.56 分钟 vs. 25.19±8.99 分钟，P=0.351）。PRC 组术后呼吸功能障碍更常见（P=0.012）；然而，神经损伤（P=0.254）、手术伤口血肿（P=0.605）、手术部位感染（P=0.679）和死亡率（P=0.812）在两组间无显著差异。在平均 26.13±19.32 个月的患者随访期间，PRC 组的再狭窄发生率高于 PAC 组（分别为 26 例，41.9%和 4 例，4.9%；P=0.003）。PRC 组和 PAC 组的脑卒中发生率（分别为 4 例，2.8%和 2 例，2.4%；P=0.679）、短暂性脑缺血发作发生率（分别为 2 例，1.4%和 0 例，0%；P=0.431）和死亡率（分别为 4 例，6.5%和 4 例，4.9%；P=0.580）无显著差异。
我们认为，在接受 CEA 的患者中，PAC 方法是一种有效且安全的颈动脉关闭方法。
