Patching plus extended exposure and tacking of the common carotid cuff may reduce the late incidence of recurrent stenosis after carotid endarterectomy

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Patching plus extended exposure and tacking of the common carotid cuff may reduce the late incidence of recurrent stenosis after carotid endarterectomy Norman R. Hertzer, MD, James F. Bena, MS Journal of Vascular Surgery Volume 58, Issue 4, Pages 926-934.e2 (October 2013) DOI: 10.1016/j.jvs.2013.04.033 Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 1 A, Before the adoption of common carotid cuff precautions in group 3, the intima and media were divided close to the proximal end of the arteriotomy (arrow). B, A digital subtraction angiogram shows severe recurrent stenosis near the carotid cuff (arrow) 6 months after using the technique shown in A. C, In an attempt to prevent recurrent stenosis in group 3, the cuff was fully exposed and secured with tacking sutures (arrow). Journal of Vascular Surgery 2013 58, 926-934.e2DOI: (10.1016/j.jvs.2013.04.033) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 2 Eligibility for analysis of recurrent carotid stenosis is shown among the three treatment groups undergoing carotid endarterectomy (CEA) in this study. ICA, Internal carotid artery. Journal of Vascular Surgery 2013 58, 926-934.e2DOI: (10.1016/j.jvs.2013.04.033) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 3 Overall influence of patching and patch material on the risks for perioperative stroke and internal carotid artery (ICA) thrombosis for the 1959 operations in this series. Journal of Vascular Surgery 2013 58, 926-934.e2DOI: (10.1016/j.jvs.2013.04.033) Copyright © 2013 Society for Vascular Surgery Terms and Conditions