Abstract:Background: Previous studies have reported that the use of a patch in carotid endarterectomy (CEA) surgery can reduce the rate of restenosis and perioperative complications. The goal of this study was to compare the short-and medium-term outcomes of endothelialization and neointimal hyperplasia of patch closure (PC) angioplasty in CEA with direct closure (DC) in a rabbit model. A bovine pericardial patch (BPP) was used in the PC procedures.Methods: Two carotid arteries were dried by air flow to simulate endart… Show more
“…8 Whilst animal studies have demonstrated endothelialisation of BP grafts used for arterial reconstruction, there is a paucity of data relating to endothelialisation of these grafts when used for IVC reconstruction in humans. 9,10 Here we show evidence that BP grafts used for IVC reconstruction demonstrate endothelialisation, however, further larger scale studies are needed to further characterise this finding.…”
Section: Discussionmentioning
confidence: 70%
“…8 Whilst animal studies have demonstrated endothelialisation of BP grafts used for arterial reconstruction, there is a paucity of data relating to endothelialisation of these grafts when used for IVC reconstruction in humans. 9,10 Here we show evidence that BP grafts used for IVC reconstruction demonstrate endothelialisation, however, further larger scale studies are needed to further characterise this finding.Image 2.Macroscopic view of the liposarcoma encasing the IVC from case 1.Image 3.Macroscopic view of the IVC (arrow) and retroperitoneal tissue from case 2.Image 4.Low power view of graft showing lumen (arrow), endothelialisation, and underlying scar with foreign body reaction (left). High power view of graft showing evidence of endothelialisation (arrow head) (right).…”
There is a paucity of research investigating revision surgery for patients with previous inferior vena cava (IVC) reconstruction using bovine pericardium (BP). To the best of our knowledge, no reports of redo procedures have been published in the medical literature. We describe two cases of redo surgery in patients with previous IVC reconstructions using BP following disease recurrence. The first case underwent resection of the BP graft with a second IVC reconstruction using BP, the second case underwent resection of the BP graft without reconstruction due to extensive thromboses. Neither case experienced perioperative complication or morbidity following their redo procedure, and previous IVC reconstruction with BP did not present significant intraoperative technical challenges. One case showed evidence of endothelialisation of the excised BP graft, however, it was not possible to definitively conclude if endothelialisation was present in the second case. Overall, these cases demonstrate that previous IVC reconstruction using BP should not be considered an absolute contraindication for redo surgery in the context of disease recurrence.
“…8 Whilst animal studies have demonstrated endothelialisation of BP grafts used for arterial reconstruction, there is a paucity of data relating to endothelialisation of these grafts when used for IVC reconstruction in humans. 9,10 Here we show evidence that BP grafts used for IVC reconstruction demonstrate endothelialisation, however, further larger scale studies are needed to further characterise this finding.…”
Section: Discussionmentioning
confidence: 70%
“…8 Whilst animal studies have demonstrated endothelialisation of BP grafts used for arterial reconstruction, there is a paucity of data relating to endothelialisation of these grafts when used for IVC reconstruction in humans. 9,10 Here we show evidence that BP grafts used for IVC reconstruction demonstrate endothelialisation, however, further larger scale studies are needed to further characterise this finding.Image 2.Macroscopic view of the liposarcoma encasing the IVC from case 1.Image 3.Macroscopic view of the IVC (arrow) and retroperitoneal tissue from case 2.Image 4.Low power view of graft showing lumen (arrow), endothelialisation, and underlying scar with foreign body reaction (left). High power view of graft showing evidence of endothelialisation (arrow head) (right).…”
There is a paucity of research investigating revision surgery for patients with previous inferior vena cava (IVC) reconstruction using bovine pericardium (BP). To the best of our knowledge, no reports of redo procedures have been published in the medical literature. We describe two cases of redo surgery in patients with previous IVC reconstructions using BP following disease recurrence. The first case underwent resection of the BP graft with a second IVC reconstruction using BP, the second case underwent resection of the BP graft without reconstruction due to extensive thromboses. Neither case experienced perioperative complication or morbidity following their redo procedure, and previous IVC reconstruction with BP did not present significant intraoperative technical challenges. One case showed evidence of endothelialisation of the excised BP graft, however, it was not possible to definitively conclude if endothelialisation was present in the second case. Overall, these cases demonstrate that previous IVC reconstruction using BP should not be considered an absolute contraindication for redo surgery in the context of disease recurrence.
Background:
Carotid endarterectomy (CEA) has been the standard therapy for carotid artery stenosis (CAS). Modified eversion carotid endarterectomy (mECEA) was recently introduced to treat CAS. However, the short-term safety and long-term efficacy of mECEA are still controversial among studies. This systematic review aims to summarize the current literatures about safety and efficacy of mECEA in treating CAS.
Methods:
A systematic review of mECEA was conducted in the main bibliographic databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Clinical studies on the safety and efficacy of mECEA in treating CAS with clinical results of transient ischemic attack (TIA), stroke, death, and restenosis were included.
Results:
The initial search and screening found 15 references from the main databases, and 7 studies were finally included after full-text article assessment, which consisted of 3 single-arm studies and 4 comparative studies. The risks of postoperative complications including TIA, stroke, myocardial infarction (MI), and death ranged from 1.1% to 2%, 0% to 2.5%, 0% to 4.4%, and 0% to 2.32%, respectively. The mECEA was significantly related to lower risk of carotid artery occlusion, incision numbness, and shorter lengths of stay in hospital and average scar when separately compared with conventional CEA (cCEA), CEA with patch closure (pCEA), and eversion CEA (eCEA).
Conclusions:
The mECEA is a promising surgical option for CAS with acceptable clinical outcomes. In order to prove its safety and efficacy, future practices need to be conducted by more medical workers in more large-scale trials.
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