Geometric dimension changes with carotid endarterectomy reconstruction

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Presentation transcript:

Geometric dimension changes with carotid endarterectomy reconstruction Joseph P. Archie, PhD, MD Journal of Vascular Surgery Volume 25, Issue 3, Pages 488-498 (March 1997) DOI: 10.1016/S0741-5214(97)70259-3 Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Carotid artery schematic illustrating the six linear dimensions measured before carotid endarectomy (CEA; left) and after patch reconstruction (right). The major and minor diameters (A and B) of the elliptical common carotid bulb were measured as shown on the far right and the maximum diameter of curvature, A2/B, calculated. Journal of Vascular Surgery 1997 25, 488-498DOI: (10.1016/S0741-5214(97)70259-3) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Internal carotid (IC) bulb diameter before (dark bars) and after (light bars) CEA for all 562 arteries (A), 302 male arteries (B), and 260 female arteries (C) by type of reconstruction. Bars are mean ± 2 SE. There are 389 vein patches, 50 Dacron 1 (DAC-1) patches (cut from a larger piece), 96 Dacron 2 (DAC-2) patches (precut 8 mm), 11 polytetrafluoroethylene (PTFE) patches, and 16 primary closures. By unpaired t testing all vein (p < 0.001) and DAC-1 (p < 0.01) dimensions increased significantly with CEA, as did DAC-2 in women (p < 0.01). The other two synthetic patches did not produce a statistically significant increase. The decrease in diameter in the primary closure group was not statistically significant. By paired t testing the internal carotid bulb diameter increased in all patch reconstructions and decreased in primary closure (p < 0.001 for all except in DAC-2 which was p < 0.05). Journal of Vascular Surgery 1997 25, 488-498DOI: (10.1016/S0741-5214(97)70259-3) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Internal carotid (IC) bulb diameter before (dark bars) and after (light bars) CEA for all 562 arteries (A), 302 male arteries (B), and 260 female arteries (C) by type of reconstruction. Bars are mean ± 2 SE. There are 389 vein patches, 50 Dacron 1 (DAC-1) patches (cut from a larger piece), 96 Dacron 2 (DAC-2) patches (precut 8 mm), 11 polytetrafluoroethylene (PTFE) patches, and 16 primary closures. By unpaired t testing all vein (p < 0.001) and DAC-1 (p < 0.01) dimensions increased significantly with CEA, as did DAC-2 in women (p < 0.01). The other two synthetic patches did not produce a statistically significant increase. The decrease in diameter in the primary closure group was not statistically significant. By paired t testing the internal carotid bulb diameter increased in all patch reconstructions and decreased in primary closure (p < 0.001 for all except in DAC-2 which was p < 0.05). Journal of Vascular Surgery 1997 25, 488-498DOI: (10.1016/S0741-5214(97)70259-3) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Internal carotid (IC) bulb diameter before (dark bars) and after (light bars) CEA for all 562 arteries (A), 302 male arteries (B), and 260 female arteries (C) by type of reconstruction. Bars are mean ± 2 SE. There are 389 vein patches, 50 Dacron 1 (DAC-1) patches (cut from a larger piece), 96 Dacron 2 (DAC-2) patches (precut 8 mm), 11 polytetrafluoroethylene (PTFE) patches, and 16 primary closures. By unpaired t testing all vein (p < 0.001) and DAC-1 (p < 0.01) dimensions increased significantly with CEA, as did DAC-2 in women (p < 0.01). The other two synthetic patches did not produce a statistically significant increase. The decrease in diameter in the primary closure group was not statistically significant. By paired t testing the internal carotid bulb diameter increased in all patch reconstructions and decreased in primary closure (p < 0.001 for all except in DAC-2 which was p < 0.05). Journal of Vascular Surgery 1997 25, 488-498DOI: (10.1016/S0741-5214(97)70259-3) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 IC before (dark bars) and after (light bars) CEA for all 562 arteries (A), 302 male arteries (B), and 260 female arteries (C) by type of reconstruction. Bars are mean ± 2 SE. There are 389 vein patches, 50 DAC-1 patches (cut from larger piece), 96 DAC-2 patches (precut 8 mm), 11 PTFE patches, and 16 primary closures. By both paired and unpaired t testing, all patch reconstructions increased this dimension (p < 0.001). The changes with primary closure were not significant by either method of testing. Journal of Vascular Surgery 1997 25, 488-498DOI: (10.1016/S0741-5214(97)70259-3) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 IC before (dark bars) and after (light bars) CEA for all 562 arteries (A), 302 male arteries (B), and 260 female arteries (C) by type of reconstruction. Bars are mean ± 2 SE. There are 389 vein patches, 50 DAC-1 patches (cut from larger piece), 96 DAC-2 patches (precut 8 mm), 11 PTFE patches, and 16 primary closures. By both paired and unpaired t testing, all patch reconstructions increased this dimension (p < 0.001). The changes with primary closure were not significant by either method of testing. Journal of Vascular Surgery 1997 25, 488-498DOI: (10.1016/S0741-5214(97)70259-3) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 IC before (dark bars) and after (light bars) CEA for all 562 arteries (A), 302 male arteries (B), and 260 female arteries (C) by type of reconstruction. Bars are mean ± 2 SE. There are 389 vein patches, 50 DAC-1 patches (cut from larger piece), 96 DAC-2 patches (precut 8 mm), 11 PTFE patches, and 16 primary closures. By both paired and unpaired t testing, all patch reconstructions increased this dimension (p < 0.001). The changes with primary closure were not significant by either method of testing. Journal of Vascular Surgery 1997 25, 488-498DOI: (10.1016/S0741-5214(97)70259-3) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Common carotid (CC) bulb major diameter before (dark bars) and after (light bars) CEA for all 562 arteries (A), 302 male arteries (B), and 260 female arteries (C) by type of reconstruction. Bars are mean ± 2 SE. There are 389 vein patches, 50 DAC-1 patches (cut from larger piece), 96 DAC-2 patches (precut 8 mm), 11 PTFE patches, and 16 primary closures. By unpaired t testing, only vein patching increased this dimension (p < 0.01). By paired t testing, all patch material increased this dimension (p < 0.01, except DAC-2, p < 0.05). There were no statistically changes in the primary closure group by either method of testing. Journal of Vascular Surgery 1997 25, 488-498DOI: (10.1016/S0741-5214(97)70259-3) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Common carotid (CC) bulb major diameter before (dark bars) and after (light bars) CEA for all 562 arteries (A), 302 male arteries (B), and 260 female arteries (C) by type of reconstruction. Bars are mean ± 2 SE. There are 389 vein patches, 50 DAC-1 patches (cut from larger piece), 96 DAC-2 patches (precut 8 mm), 11 PTFE patches, and 16 primary closures. By unpaired t testing, only vein patching increased this dimension (p < 0.01). By paired t testing, all patch material increased this dimension (p < 0.01, except DAC-2, p < 0.05). There were no statistically changes in the primary closure group by either method of testing. Journal of Vascular Surgery 1997 25, 488-498DOI: (10.1016/S0741-5214(97)70259-3) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Common carotid (CC) bulb major diameter before (dark bars) and after (light bars) CEA for all 562 arteries (A), 302 male arteries (B), and 260 female arteries (C) by type of reconstruction. Bars are mean ± 2 SE. There are 389 vein patches, 50 DAC-1 patches (cut from larger piece), 96 DAC-2 patches (precut 8 mm), 11 PTFE patches, and 16 primary closures. By unpaired t testing, only vein patching increased this dimension (p < 0.01). By paired t testing, all patch material increased this dimension (p < 0.01, except DAC-2, p < 0.05). There were no statistically changes in the primary closure group by either method of testing. Journal of Vascular Surgery 1997 25, 488-498DOI: (10.1016/S0741-5214(97)70259-3) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 CC bulb maximum diameter of curvature before (dark bars) and after (light bars) CEA diameter for all 562 arteries (A), 302 male arteries (B), and 260 female arteries (C) by type of reconstruction. Bars are mean ± 2 SE. There are 389 vein patches, 50 DAC-1 patches (cut from larger piece), 96 DAC-2 patches (precut 8 mm), 11 PTFE patches, and 16 primary closures. There were no statistically significant changes by either paired or unpaired t testing in any group or subgroup. Journal of Vascular Surgery 1997 25, 488-498DOI: (10.1016/S0741-5214(97)70259-3) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 CC bulb maximum diameter of curvature before (dark bars) and after (light bars) CEA diameter for all 562 arteries (A), 302 male arteries (B), and 260 female arteries (C) by type of reconstruction. Bars are mean ± 2 SE. There are 389 vein patches, 50 DAC-1 patches (cut from larger piece), 96 DAC-2 patches (precut 8 mm), 11 PTFE patches, and 16 primary closures. There were no statistically significant changes by either paired or unpaired t testing in any group or subgroup. Journal of Vascular Surgery 1997 25, 488-498DOI: (10.1016/S0741-5214(97)70259-3) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 CC bulb maximum diameter of curvature before (dark bars) and after (light bars) CEA diameter for all 562 arteries (A), 302 male arteries (B), and 260 female arteries (C) by type of reconstruction. Bars are mean ± 2 SE. There are 389 vein patches, 50 DAC-1 patches (cut from larger piece), 96 DAC-2 patches (precut 8 mm), 11 PTFE patches, and 16 primary closures. There were no statistically significant changes by either paired or unpaired t testing in any group or subgroup. Journal of Vascular Surgery 1997 25, 488-498DOI: (10.1016/S0741-5214(97)70259-3) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 6 CC bulb eccentricity before (dark bars) and after (light bars) CEA for all 562 arteries (A), 302 male arteries (B), and 260 female arteries (C) by type of reconstruction. Bars are mean ± 2 SE. There are 389 vein patches, 50 DAC-1 patches (cut from larger piece), 96 DAC-2 patches (precut 8 mm), 11 PTFE patches, and 16 primary closures. By both paired and unpaired t testing all patch groups and subgroups decreased this dimension (p < 0.01). There was no change produced by primary closure (p < 0.05) by either method. Journal of Vascular Surgery 1997 25, 488-498DOI: (10.1016/S0741-5214(97)70259-3) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 6 CC bulb eccentricity before (dark bars) and after (light bars) CEA for all 562 arteries (A), 302 male arteries (B), and 260 female arteries (C) by type of reconstruction. Bars are mean ± 2 SE. There are 389 vein patches, 50 DAC-1 patches (cut from larger piece), 96 DAC-2 patches (precut 8 mm), 11 PTFE patches, and 16 primary closures. By both paired and unpaired t testing all patch groups and subgroups decreased this dimension (p < 0.01). There was no change produced by primary closure (p < 0.05) by either method. Journal of Vascular Surgery 1997 25, 488-498DOI: (10.1016/S0741-5214(97)70259-3) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 6 CC bulb eccentricity before (dark bars) and after (light bars) CEA for all 562 arteries (A), 302 male arteries (B), and 260 female arteries (C) by type of reconstruction. Bars are mean ± 2 SE. There are 389 vein patches, 50 DAC-1 patches (cut from larger piece), 96 DAC-2 patches (precut 8 mm), 11 PTFE patches, and 16 primary closures. By both paired and unpaired t testing all patch groups and subgroups decreased this dimension (p < 0.01). There was no change produced by primary closure (p < 0.05) by either method. Journal of Vascular Surgery 1997 25, 488-498DOI: (10.1016/S0741-5214(97)70259-3) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 7 CC bulb circumference before (dark bars) and after (light bars) CEA for all 562 arteries (A), 302 male arteries (B), and 260 female arteries (C) by type of reconstruction. Bars are mean ± 2 SE. There are 389 vein patches, 50 DAC-1 patches (cut from larger piece), 96 DAC-2 patches (precut 8 mm), 11 PTFE patches, and 16 primary closures. Patching increased this dimension (p < 0.01, unpaired t test; p < 0.001, unpaired t test), except for PTFE in women (p < 0.05). There was no statistically significant change produced by primary closure by either method of testing. Journal of Vascular Surgery 1997 25, 488-498DOI: (10.1016/S0741-5214(97)70259-3) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 7 CC bulb circumference before (dark bars) and after (light bars) CEA for all 562 arteries (A), 302 male arteries (B), and 260 female arteries (C) by type of reconstruction. Bars are mean ± 2 SE. There are 389 vein patches, 50 DAC-1 patches (cut from larger piece), 96 DAC-2 patches (precut 8 mm), 11 PTFE patches, and 16 primary closures. Patching increased this dimension (p < 0.01, unpaired t test; p < 0.001, unpaired t test), except for PTFE in women (p < 0.05). There was no statistically significant change produced by primary closure by either method of testing. Journal of Vascular Surgery 1997 25, 488-498DOI: (10.1016/S0741-5214(97)70259-3) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 7 CC bulb circumference before (dark bars) and after (light bars) CEA for all 562 arteries (A), 302 male arteries (B), and 260 female arteries (C) by type of reconstruction. Bars are mean ± 2 SE. There are 389 vein patches, 50 DAC-1 patches (cut from larger piece), 96 DAC-2 patches (precut 8 mm), 11 PTFE patches, and 16 primary closures. Patching increased this dimension (p < 0.01, unpaired t test; p < 0.001, unpaired t test), except for PTFE in women (p < 0.05). There was no statistically significant change produced by primary closure by either method of testing. Journal of Vascular Surgery 1997 25, 488-498DOI: (10.1016/S0741-5214(97)70259-3) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions