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

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Presentation on theme: "Steven S. Weber, MD, Alan J. Annenberg, MD, Creighton B"— Presentation transcript:

1 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 (April 2014) DOI: /j.jvs Copyright © 2014 Society for Vascular Surgery Terms and Conditions

2 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  , DOI: ( /j.jvs ) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

3 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  , DOI: ( /j.jvs ) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

4 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  , DOI: ( /j.jvs ) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

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