Does the choice of material influence early morbidity in patients undergoing carotid patch angioplasty?
Does the choice of material influence early morbidity in patients undergoing carotid patch angioplasty?
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DOI：
10.1016/s0039-6060(96)80116-4
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发表时间：
1996-03-01
期刊：
影响因子：
3.8
通讯作者：
Kohl, RD
中科院分区：
文献类型：
--
作者：
Katz, SG;Kohl, RD
背景本研究旨在确定材料的选择是否影响接受颈动脉补片血管成形术患者的早期发病率。在接受颈动脉内膜切除术之前，190名患者随机接受207个补片，补片使用涤纶（USCI Sauvage针织丝绒）或从大腿获取的隐静脉。共施行涤纶补片血管成形术107例，静脉补片血管成形术100例。两组患者的年龄、性别、术前危险因素或手术指征无显著差异（每个变量p > 0.25）。在接受涤纶补片血管成形术的患者中，发生了3例卒中（2例暂时性和1例永久性）、7例出血事件（需要再次手术）和2例颈部伤口感染（需要再次住院）。最后32名使用涤纶贴片闭合的患者的抗凝作用逆转，没有出现出血并发症。接受静脉补片缝合的患者的并发症包括1例致命的围手术期卒中、2例需要再次手术的出血事件（包括1例补片破裂）和3例需要住院的腹股沟感染。两组在围手术期卒中（p = 0.62）、出血（p = 0.17）或感染（p => 0.67）的发生率方面无显著差异。使用涤纶或静脉进行颈动脉补片血管成形术的并发症发生率较低，并且补片材料的选择在临床上不会影响患者的发病率。但是，建议逆转抗凝治疗，以尽量减少接受涤纶补片血管成形术的患者的出血并发症。
Background. This study was undertaken to determine whether the choice of material influences the early morbidity of patients undergoing carotid patch angioplasty.Methods. Before undergoing carotid endarterectomy, 190 patients were randomized to receive 207 patch closures with either Dacron (USCI Sauvage knitted velour) or saphenous vein harvested from the thigh.Results. One hundred seven Dacron and 100 vein patch angioplasties were performed. No significant difference was seen between the two groups in patient age, sex, preoperative risk factors, or indication for operation (p > 0.25 for each variable). Among the patients undergoing Dacron patch angioplasty three strokes (two temporary and one permanent), seven episodes of bleeding requiring reoperation, and two neck wound infections requiring rehospitalization occurred. The final 32 patients with Dacron patch closures had their anticoagulation reversed and had no bleeding complications. Complications in patients undergoing vein patch closure included one fatal perioperative stroke, two episodes of bleeding requiring reoperation including one patch rupture, and three groin infections requiring hospitalization. No significant difference was seen between the two groups in the rate of perioperative stroke (p = 0.62), episodes of bleeding (p = 0.17), or infection (p => 0.67).Conclusions. Carotid patch angioplasty can be performed with an acceptably low complication rate with either Dacron or vein, and the choice of patch material does not clinically affect patient morbidity. However, reversal of anticoagulation is recommended to minimize bleeding complications in patients undergoing Dacron patch angioplasty.