Repair of carotid endarterectomy with a collagen-impregnated fabric graft

Saphenous vein patch closure of carotid endarterectomies may decrease the risk of acute postoperative occlusion and recurrent stenosis. However, the disadvantages of a vein patch include postoperative rupture and pseudoaneurysm formation. Object. The authors sought to assess the effectiveness of collagen-impregnated fabric grafts as substitutes for saphenous vein grafts. Methods. In this report the authors prospectively analyzed 290 consecutive carotid endarterectomies in which a secondary closure was accomplished using a knitted double-velour graft. The 30-day major neurological morbidity and mortality rate was 1.7%. There were no postoperative occlusions or wound hematomas. The rate of recurrent carotid artery stenosis was less than 1%, and the graft site in one patient became infected. Conclusions. For surgeons who prefer a secondary closure of carotid endarterectomies, the synthetic graft may prove to be a viable alternative to a saphenous vein.