Interposition Grafts for Difficult Carotid Artery Reconstruction: A 17-Year Experience

Amir H. Dorafshar, Todd D. Reil, Samuel S. Ahn, William J. Quinones-Baldrich, Wesley S. Moore

Research output: Contribution to journalArticlepeer-review

Abstract

Carotid interposition grafts (CIP) for carotid artery revascularization can be a viable alternative to carotid endarterectomy (CEA) or carotid artery stenting (CAS) for complex carotid disease. This is a retrospective review of the UCLA 17-year experience with CIP for carotid reconstruction. Carotid operations performed between 1988 and 2005 revealed 41 CIP procedures in 39 patients using polytetrafluoroethylene (PTFE, n = 31) or reversed greater saphenous vein (Vein) (n = 10). Perioperative data and long-term follow-up for each conduit were statistically compared. There were no significant differences in demographics, risk factors, operative indications, complications, or 30-day perioperative deaths. There was one postoperative stroke in each group, for an overall stroke rate of 4.9% (PTFE 3.2%, Vein 10%). There was one asymptomatic occlusion and there were two high-grade restenoses in the PTFE group compared with one asymptomatic occlusion and one high-grade restenosis in the Vein group. Overall primary patency was 90% and the assisted primary patency was 97% for the PTFE group (mean follow-up 50 months), whereas primary patency was 80% (mean follow-up 30 months) in the Vein group. CIP is a safe and effective technique with excellent long-term follow-up for complex carotid reconstruction when CEA or CAS may be contraindicated.

Original languageEnglish (US)
Pages (from-to)63-69
Number of pages7
JournalAnnals of Vascular Surgery
Volume22
Issue number1
DOIs
StatePublished - Jan 1 2008

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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