Utilizarea venei faciale ca material de angioplastie în endarterectomia carotidiană | [Using facial vein as material angioplasty in carotid endarterectomy]

Abstract

Introduction: Carotid endarterectomy (CEA) is the „gold standard” for the treatment of carotid stenosis. In this study, we evaluate the results after using an alternative patch material for arteriotomy closure. Material and methods: This study is a retrospective, observational study, in which we have compared 2 groups of 8 patients operated on in our clinic in 2008-2012, the first group of 8 patients with CEA and facial vein patch, the second group of 8 consecutive patients with CEA and PTFE patch. Results: In the A group there were 6 males, in the B group 5 males. Group A had a median age of 60 years, group B had a median age of 60.5 years. All patients were operated for severe carotid stenosis. We evaluated the time of surgery, which varied for group A between 70 and 85 minutes, with a median of 77 minutes, and for group B between 75 and 100 minutes, with a median of 88 minutes. We observed a significant difference between the 2 groups regarding the time of surgery, in favor of group A (P = 0.010). Conclusions: The advantages of an autologous venous material are represented by an endothelised patch, reduction of desendothelised area, and higher resistance to infections. The use of facial veins for endarterectomy patches needs the same incision, elevating the cost-efficiency of the procedure, and significantly reducing the operating time compared with PTFE due to faster achievement of hemostasis.