Steven S. Weber, MD, Alan J. Annenberg, MD, Creighton B

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Presentation transcript:

Early pseudoaneurysm degeneration in biologic extracellular matrix patch for carotid repair Steven S. Weber, MD, Alan J. Annenberg, MD, Creighton B. Wright, MD, Timothy S. Braverman, MD, Charles L. Mesh, MD Journal of Vascular Surgery Volume 59, Issue 4, Pages 1116-1118 (April 2014) DOI: 10.1016/j.jvs.2013.05.012 Copyright © 2014 Society for Vascular Surgery Terms and Conditions

Fig 1 Carotid patch pseudoaneurysm. a, Axial computed tomography (CT) image. b, Coronal CT image demonstrating lobular superior extension (arrow). c, Sagittal CT image. d, Operative dissection from same patient showing common (CCA) and internal carotid (ICA) arteries with large small intestinal submucosa (SIS) patch pseudoaneurysm. Journal of Vascular Surgery 2014 59, 1116-1118DOI: (10.1016/j.jvs.2013.05.012) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

Fig 2 Excised patch and adjacent carotid artery. a, Patch pseudoaneurysm (superior aspect) and normal postendarterectomy arterial architecture (inferior aspect) – hematoxylin and eosin stain. b, Masson Trichrome stain (low and high powers) delineates collagen fibers as basophilic. Inferior aspect shows well-organized collagen fibers of neointima luminal to normal smooth muscle. Middle aspect demonstrates acellular collagen of small intestinal submucosa (SIS) patch (∗) and less organized transmural collagen fibers. Superior aspect shows disorganized collagen fibers of patch pseudoaneurysm. S, Suture. Journal of Vascular Surgery 2014 59, 1116-1118DOI: (10.1016/j.jvs.2013.05.012) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

Fig 3 Antibody stains for endothelial cells (P34) and macrophages (P68) in area of SIS patch (mid-portion of Fig 1, b). a, Low and high power hematoxylin and eosin stain of small intestinal submucosa (SIS) remnant (*) and adjacent cellular infiltrate (arrow). b, Brown P34 stain shows neovascularization indicating synthetic processes. c, P68, which also stains brown, shows macrophage infiltration consistent with ongoing destructive process. Journal of Vascular Surgery 2014 59, 1116-1118DOI: (10.1016/j.jvs.2013.05.012) Copyright © 2014 Society for Vascular Surgery Terms and Conditions