9674
document
Bovine pericardium vs dacron for patch angioplasty after carotid endarterectomy : a prospective randomized study . HYPOTHESIS Bovine pericardium ( BP ) demonstrates improved intraoperative hemostasis and equivalent perioperative morbidity compared with Dacron when used as patch material for angioplasty following carotid endarterectomy . OBJECTIVE To prospectively compare BP and Dacron patch angioplasty after carotid endarterectomy in a randomized fashion . METHODS Ninety-five consecutive primary carotid endarterectomies were performed in a prospective randomized fashion in 92 patients . Fifty-one procedures were performed using BP and 44 using Dacron . Intraoperative suture line bleeding was subjectively evaluated by observing bleeding at 3 and 4 minutes following carotid cross-clamp removal and then objectively weighing the sponge used to tamponade bleeding during these time intervals . Perioperative morbidity , including cervical wound hematoma , transient ischemic attack , and stroke , and perioperative mortality were recorded . Statistical analysis was performed using paired t tests , chi ( 2 ) analysis , Fisher exact test , or multiple linear regression as appropriate . RESULTS Suture line bleeding at 3 minutes was present in 7 ( 14 % ) of 51 patients in the BP group and 24 ( 55 % ) of 44 patients in the Dacron group ( P < .001 ) . Suture line bleeding evaluated at 4 minutes was present in 2 ( 4 % ) of 51 patients in the BP group and 13 ( 30 % ) of 44 patients in the Dacron group ( P =.001 ) . Net +/- SEM sponge weight ( total intraoperative suture line bleeding ) was 6.25 +/- 0.55 g in the BP group and 16.34 +/- 1.85 g in the Dacron group ( P < .001 ) . Total suture line bleeding was significantly affected by activated clotting time ; however , multivariate analysis demonstrated that bleeding was significantly less with BP ( P < .001 ) even after adjusting for differences in activated clotting time . CONCLUSIONS Bovine pericardium demonstrated a statistically significant decrease in intraoperative suture line bleeding compared with Dacron . Handling characteristics were judged by the surgeons to be superior for BP . Therefore , we believe BP may be an alternative to Dacron when performing patch angioplasty of the carotid artery after endarterectomy .
9675
Intervention_Pharmacological
Bovine pericardium
9676
Intervention_Pharmacological
dacron
9677
Intervention_Pharmacological
Bovine pericardium ( BP )
9678
Intervention_Pharmacological
Dacron
9679
Intervention_Surgical
carotid endarterectomy
9680
Intervention_Physical
BP
9681
Intervention_Surgical
Dacron patch angioplasty
9682
Intervention_Pharmacological
BP
9683
Intervention_Surgical
Dacron
9684
Intervention_Surgical
carotid cross-clamp removal
9685
Intervention_Pharmacological
BP
9686
Intervention_Surgical
Dacron
9687
Intervention_Pharmacological
BP
9688
Intervention_Surgical
Dacron
9689
Intervention_Pharmacological
BP
9690
Intervention_Surgical
Dacron
9691
Intervention_Pharmacological
BP
9692
Intervention_Pharmacological
Bovine pericardium
9693
Intervention_Surgical
Dacron
9694
Intervention_Pharmacological
BP
9695
Intervention_Pharmacological
BP
9696
Intervention_Surgical
Dacron
9697
Outcome_Mortality
Perioperative morbidity
9698
Outcome_Physical
cervical wound hematoma
9699
Outcome_Physical
transient ischemic attack
9700
Outcome_Physical
stroke
9701
Outcome_Mortality
perioperative mortality
9702
Outcome_Physical
Suture line bleeding at 3 minutes
9703
Outcome_Physical
Suture line bleeding evaluated at 4 minutes
9704
Outcome_Physical
Net +/- SEM sponge weight ( total intraoperative suture line bleeding )
9705
Outcome_Physical
Total suture line bleeding
9706
Outcome_Adverse-effects
bleeding
9707
Participant_Condition
after carotid endarterectomy
9708
Participant_Condition
carotid endarterectomies
9709
Participant_Sample-size
92