Use of the Vascu-Guard Bovine Pericardium Patch for Arteriotomy Closure in Carotid Endarterectomy. Early and Long-Term Results

Papakostas, John C.; Avgos, Stavros; Αrnaoutoglou, Eleni; Nassis, Christos; Peroulis, Michalis; Bali, Christina; Papadopoulos, George Α.; Matsagkas, Miltiadis

doi:10.1016/j.avsg.2013.10.021

Cited by 21 publications

(23 citation statements)

References 26 publications

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“…Bovine pericardium has been associated with lower risk of infection and thrombosis compared with synthetic materials; furthermore, it does not require long-term anticoagulation. 10 , 11 , 12 The patch material has proved durable in arterial applications, most commonly as a patch for carotid endarterectomy. 10 , 13 There are several case reports of BPP used for cardiac and pulmonary reconstruction in infected fields, and they have shown good outcomes and durability.…”

Section: Discussionmentioning

confidence: 99%

The use of bovine pericardial patch for vascular reconstruction in infected fields for transplant recipients

Aroz

Spaggiari

Jeon

et al. 2017

Journal of Vascular Surgery Cases, Innovations and Techniques

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Infectious vascular complications affecting transplant recipients may lead to severe morbidity and graft loss. This is a retrospective review of vascular repair with bovine pericardial patch (BPP) in infected fields for immunosuppressed patients. BPP was used as either a patch or an interposition graft. Five cases of arterial reconstruction in infected fields using BPP were performed. There were no complications related to bleeding, thrombosis, or recurrent infection. In our limited experience, the use of BPP as a vascular patch is successful, and it represents an alternative when vascular reconstruction is needed in the context of infected fields.

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Section: Discussionmentioning

confidence: 99%

The use of bovine pericardial patch for vascular reconstruction in infected fields for transplant recipients

Aroz

Spaggiari

Jeon

et al. 2017

Journal of Vascular Surgery Cases, Innovations and Techniques

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“…The study also revealed a similar incidence of restenosis between the two patch materials (2.8% for bovine pericardium versus 3.4% for saphenous vein) and identified 4 patients who developed late aneurysmal dilatation in saphenous vein patches compared with no cases involving bovine pericardial patches [ 11 ]. Another study also reported a low incidence of restenosis (1.6%, 4/256) over 12 years in patients who underwent CEA with bovine pericardial patch angioplasty [ 12 ]. Bovine pericardium also provides the benefit of off-the-shelf availability and, has a reliable consistency and strength to allow a tight fitting closure, which yields less suture line bleeding and prevents aneurysmal dilatation [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Long-term results of surgical angioplasty for left main coronary artery stenosis: 18-year follow-up

Jeong

Lee

Kim

et al. 2015

J Cardiothorac Surg

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BackgroundThe aim of this study was to determine the long-term outcomes of surgical angioplasty for left main coronary artery (SA-LMCA) stenosis.MethodsWe retrospectively analyzed data from 24 consecutive patients (mean age, 55 years; male/female, 12/12) who underwent a surgical angioplasty for the left main coronary artery (LMCA) stenosis at our institution between 1995 and 2002. We used autologous pericardium in 7 patients and bovine pericardium in 17 patients as a patch. We evaluated the late mortality and major adverse cardiac events (MACE) rate.ResultsThere was no operative mortality. Control coronary angiography exhibited wide open and funnel-shaped LMCA in all patients. One patient was lost to follow-up. During the mean follow-up of 167 months, there were 3 sudden cardiac deaths, 4 non-cardiac related deaths, and 9 MACE with one death at reoperation. The Kaplan-Meier method identified freedom from cardiac death in 95.7, 87.0, and 82.4% of the patients, and freedom from MACE in 91.3, 69.6, and 57.7% of the patients at 5, 10, and 15 years, respectively.ConclusionsThis study demonstrated that the long-term outcomes of SA-LMCA with a pericardial patch are acceptable compared to those of coronary artery bypass grafting, despite the controversy over the indications and the patch material used.

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“…For example, in a recent series following 256 bovine pericardial patches over 12 years, there were no patch infections. 10 Another large series showed 3 infections in 457 pericardial patches (0.6%), which was not statistically different than Dacron patches (0.3%; p=0.73) or primary closure (0%; p=0.23), in up to 9 year follow up. 11 Interestingly, bovine pericardial patches have even been used in the presence of infection.…”

Section: Introductionmentioning

confidence: 89%

Pretreatment of pericardial patches with antibiotics does not alter patch healing in vivo

Bai

Kuwahara

Wang

et al. 2016

Journal of Vascular Surgery

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Introduction: Pretreatment with antibiotics is commonly performed prior to surgical implantation of prosthetic materials. We have previously shown that pericardial patches are infiltrated by macrophages and arterial stem cells after implantation into an artery. We hypothesized that antibiotic pretreatment would diminish the number of cells infiltrating into the patch, potentially affecting early neointimal formation. Methods: Bovine pericardial patches were pretreated with saline, bacitracin (500 U/ml), or cephalexin (10 mg/ml) for 30 minutes prior to implantation into the Wistar rat infrarenal aorta. Patches were retrieved on day 7 or day 30, and analyzed for histology and cell infiltration; markers of proliferation, apoptosis, vascular cell identity, and M1 and M2 macrophage subtypes were examined using immunofluorescence and immunohistochemistry. Extracted proteins were analyzed by Western blot. Results: At day 7, pericardial patches pretreated with either bacitracin or cephalexin showed similar amounts of neointimal thickening (p=0.55) and cellular infiltration (p=0.42) compared to control patches. Patches pretreated with antibiotics showed similar proliferation (p=0.09) and apoptosis (p=0.84) as control patches. The cell composition of the neointima in pretreated patches was similar to control patches, with a thin endothelial layer overlying a thin layer of SMC (p=0.45), and containing similar numbers of CD34-positive (p=0.26) and VEGFR2-positive (p=0.31) cells. Interestingly, within the body of the patch, there were fewer macrophages (p=0.0003) and a trend towards fewer EPC (p=0.051). There were no M1 macrophages in or around any of the patches; M2 macrophages were present around the patches and there was no difference in numbers of M2 macrophages surrounding control patches and patches pretreated with antibiotics (p=0.24). There was no difference in neointimal thickness at day 30 between control patches and patches pretreated with antibiotics (p=0.52). Conclusions: Pretreatment of bovine pericardial patches with the antibiotics bacitracin or cephalexin has no detrimental effect on early patch healing, with similar neointimal thickness, cellular infiltration, and numbers of M2 macrophages compared to control patches. These results suggest that the host vessel response to patch angioplasty using pericardial patches is adaptive remodeling, e.g. arterial healing.

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Use of the Vascu-Guard Bovine Pericardium Patch for Arteriotomy Closure in Carotid Endarterectomy. Early and Long-Term Results

Cited by 21 publications

References 26 publications

The use of bovine pericardial patch for vascular reconstruction in infected fields for transplant recipients

The use of bovine pericardial patch for vascular reconstruction in infected fields for transplant recipients

Long-term results of surgical angioplasty for left main coronary artery stenosis: 18-year follow-up

Pretreatment of pericardial patches with antibiotics does not alter patch healing in vivo

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