• Annals of surgery · Jun 1999

    Randomized Controlled Trial Comparative Study Clinical Trial

    Analysis of regression of postoperative carotid stenosis from prospective randomized trial of carotid endarterectomy comparing primary closure versus patching.

    • A F AbuRahma, P A Robinson, and D L Stickler.
    • Department of Surgery, Robert C. Byrd Health Sciences Center of West Virginia University, Charleston, USA.
    • Ann. Surg. 1999 Jun 1; 229 (6): 767773767-72; discussion 772-3.

    Background And PurposeRecurrent stenosis after carotid endarterectomy (CEA) has been reported to vary between a few percent and 30%. Regression of recurrent stenosis has been reported sporadically in the literature, but studies analyzing the factors affecting regression are lacking. This study analyzed factors affecting the regression of postoperative stenosis from a prospective randomized trial of CEA comparing primary closure (PC) versus patching.Patient Population And MethodsThree hundred ninety-nine CEAs were randomized into three groups: 135 PCs, 135 polytetrafluoroethylene patch closures (PTFE), and 130 vein patch closures (VPC). Postoperative duplex ultrasounds were done at 1, 6, and 12 months, and then yearly. The subgroup of these CEAs that exhibited postoperative stenosis was followed for possible regression of the stenosis. Analyses of various risk factors were examined for possible association with regression of recurrent stenosis. Mean follow-up was 46 months.ResultsOf 105 postoperative stenoses, regression was noted in 6/64 (9%) in PC, 6/13 (46%) in PTFE, and 10/28 (36%) in VPC. Overall, 22 recurrent stenoses regressed; 19 regressed to normal and 3 regressed from 50% to 80% stenosis to 20% to <50% stenosis. The mean time to regression was 383 days. Regression was more common in patching than PC. Both VPC and PTFE had significantly more regression than PC. When stenoses of 50% to 80% were analyzed, patching had more regression than PC. None of the recurrent stenoses > or = 80% regressed. There was no association between regression and other factors, including gender, hypertension, diabetes mellitus, coronary artery disease, smoking, internal carotid artery diameter, hyperlipidemia, hypercholesterolemia, or aspirin intake.ConclusionsRegression of recurrent stenosis was associated more strongly with patching than with PC. There was no association between regression and other factors.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…