Postoperative Complications of Carotid Patching: Pseudoaneurysm and Infection
Patch angioplasty after carotid endarterectomy has been advocated to improve results by decreasing the incidence of recurrent stenosis and postoperative carotid thrombosis. Aneurysmal and infectious complications may be secondary to use of prosthetic materials in arterial reconstruction. We report f...
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Veröffentlicht in: | Annals of vascular surgery 2003-03, Vol.17 (2), p.156-161 |
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description | Patch angioplasty after carotid endarterectomy has been advocated to improve results by decreasing the incidence of recurrent stenosis and postoperative carotid thrombosis. Aneurysmal and infectious complications may be secondary to use of prosthetic materials in arterial reconstruction. We report four patients who developed late operative site complications related to carotid patching. All four of our patients had delayed pseudoaneurysms and three had infection related to the Dacron patch. In a typical case, a 57-year-old who had a right carotid endarterectomy in 1994 presented with a 1-month history of an enlarging right neck mass 7 years later. Imaging revealed a 6 × 4 cm pseudoaneurysm originating from an opening between the patch graft and the old endarterectomized carotid wall. Analysis of the literature disclosed an additional 45 patients who had pseudoaneurysms and/or infection related to carotid patching, most frequently with Dacron. We postulate that a low-grade
Staphylococcus epidermidis infection of the foreign body patch may be the etiology. Autogenous saphenous vein interposition graft and antimicrobials effective against gram-positive organisms corrected the pseudoaneurysm. Although the benefits of routine carotid patching may include a decrease in restenosis, this advantage must be weighed against the risk of late pseudoaneurysm and/or infection when a prosthetic patch is used to closed the endarterectomy site. |
doi_str_mv | 10.1007/s10016-001-0400-5 |
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Staphylococcus epidermidis infection of the foreign body patch may be the etiology. Autogenous saphenous vein interposition graft and antimicrobials effective against gram-positive organisms corrected the pseudoaneurysm. Although the benefits of routine carotid patching may include a decrease in restenosis, this advantage must be weighed against the risk of late pseudoaneurysm and/or infection when a prosthetic patch is used to closed the endarterectomy site.</description><identifier>ISSN: 0890-5096</identifier><identifier>EISSN: 1615-5947</identifier><identifier>DOI: 10.1007/s10016-001-0400-5</identifier><identifier>PMID: 12616349</identifier><identifier>CODEN: AVSUEV</identifier><language>eng</language><publisher>Netherlands: Elsevier Inc</publisher><subject>Aged ; Angioplasty - adverse effects ; Blood Vessel Prosthesis - adverse effects ; Blood Vessel Prosthesis - microbiology ; Blood Vessel Prosthesis Implantation - methods ; Carotid Arteries - surgery ; Carotid-Cavernous Sinus Fistula - microbiology ; Carotid-Cavernous Sinus Fistula - surgery ; Endarterectomy, Carotid - adverse effects ; Humans ; Male ; Middle Aged ; Polyethylene Terephthalates - adverse effects ; Postoperative Complications ; Prosthesis-Related Infections - microbiology ; Prosthesis-Related Infections - surgery ; Reoperation ; Retrospective Studies ; Saphenous Vein - transplantation ; Staphylococcal Infections - microbiology ; Staphylococcus epidermidis</subject><ispartof>Annals of vascular surgery, 2003-03, Vol.17 (2), p.156-161</ispartof><rights>2003 Annals of Vascular Surgery, Inc.</rights><rights>Annals of Vascular Surgery Inc. 2003</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-ff75ff5f24cc048d8a4a90917227c2d275c80b490659fc5ed2120c36b6a8199d3</citedby><cites>FETCH-LOGICAL-c442t-ff75ff5f24cc048d8a4a90917227c2d275c80b490659fc5ed2120c36b6a8199d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1007/s10016-001-0400-5$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12616349$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Borazjani, Boris H.</creatorcontrib><creatorcontrib>Wilson, Samuel E.</creatorcontrib><creatorcontrib>Fujitani, Roy M.</creatorcontrib><creatorcontrib>Gordon, Ian</creatorcontrib><creatorcontrib>Mueller, Mark</creatorcontrib><creatorcontrib>Williams, Russell A.</creatorcontrib><title>Postoperative Complications of Carotid Patching: Pseudoaneurysm and Infection</title><title>Annals of vascular surgery</title><addtitle>Ann Vasc Surg</addtitle><description>Patch angioplasty after carotid endarterectomy has been advocated to improve results by decreasing the incidence of recurrent stenosis and postoperative carotid thrombosis. Aneurysmal and infectious complications may be secondary to use of prosthetic materials in arterial reconstruction. We report four patients who developed late operative site complications related to carotid patching. All four of our patients had delayed pseudoaneurysms and three had infection related to the Dacron patch. In a typical case, a 57-year-old who had a right carotid endarterectomy in 1994 presented with a 1-month history of an enlarging right neck mass 7 years later. Imaging revealed a 6 × 4 cm pseudoaneurysm originating from an opening between the patch graft and the old endarterectomized carotid wall. Analysis of the literature disclosed an additional 45 patients who had pseudoaneurysms and/or infection related to carotid patching, most frequently with Dacron. We postulate that a low-grade
Staphylococcus epidermidis infection of the foreign body patch may be the etiology. Autogenous saphenous vein interposition graft and antimicrobials effective against gram-positive organisms corrected the pseudoaneurysm. Although the benefits of routine carotid patching may include a decrease in restenosis, this advantage must be weighed against the risk of late pseudoaneurysm and/or infection when a prosthetic patch is used to closed the endarterectomy site.</description><subject>Aged</subject><subject>Angioplasty - adverse effects</subject><subject>Blood Vessel Prosthesis - adverse effects</subject><subject>Blood Vessel Prosthesis - microbiology</subject><subject>Blood Vessel Prosthesis Implantation - methods</subject><subject>Carotid Arteries - surgery</subject><subject>Carotid-Cavernous Sinus Fistula - microbiology</subject><subject>Carotid-Cavernous Sinus Fistula - surgery</subject><subject>Endarterectomy, Carotid - adverse effects</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Polyethylene Terephthalates - adverse effects</subject><subject>Postoperative Complications</subject><subject>Prosthesis-Related Infections - microbiology</subject><subject>Prosthesis-Related Infections - surgery</subject><subject>Reoperation</subject><subject>Retrospective Studies</subject><subject>Saphenous Vein - transplantation</subject><subject>Staphylococcal Infections - microbiology</subject><subject>Staphylococcus epidermidis</subject><issn>0890-5096</issn><issn>1615-5947</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEtLAzEUhYMotlZ_gBsZ3EeTNMlMdCWDj0LFLnQd0jw0xZmMyUyh_96UKbhzcy43nHPC_QC4xOgGI1TepqyYwywQUYQgOwJTzDGDTNDyGExRJfIjEnwCzlLaZB-paHUKJphwzOdUTMHrKqQ-dDaq3m9tUYem-_Y6L6FNRXBFrWLovSlWqtdfvv28K1bJDiao1g5xl5pCtaZYtM7qfeQcnDj1nezFYc7Ax9Pje_0Cl2_Pi_phCTWlpIfOlcw55gjVGtHKVIoqgQQuCSk1MaRkukJrKhBnwmlmDcEE6Tlfc1VhIcx8Bq7H3i6Gn8GmXm7CENv8pSSYsnw3LrMJjyYdQ0rROtlF36i4kxjJPT858pNZ5J6fZDlzdSge1o01f4kDsGy4Hw02n7f1NsqkvW21NT5mBtIE_0_9L6DAffE</recordid><startdate>20030301</startdate><enddate>20030301</enddate><creator>Borazjani, Boris H.</creator><creator>Wilson, Samuel E.</creator><creator>Fujitani, Roy M.</creator><creator>Gordon, Ian</creator><creator>Mueller, Mark</creator><creator>Williams, Russell A.</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope></search><sort><creationdate>20030301</creationdate><title>Postoperative Complications of Carotid Patching: Pseudoaneurysm and Infection</title><author>Borazjani, Boris H. ; Wilson, Samuel E. ; Fujitani, Roy M. ; Gordon, Ian ; Mueller, Mark ; Williams, Russell A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-ff75ff5f24cc048d8a4a90917227c2d275c80b490659fc5ed2120c36b6a8199d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Aged</topic><topic>Angioplasty - adverse effects</topic><topic>Blood Vessel Prosthesis - adverse effects</topic><topic>Blood Vessel Prosthesis - microbiology</topic><topic>Blood Vessel Prosthesis Implantation - methods</topic><topic>Carotid Arteries - surgery</topic><topic>Carotid-Cavernous Sinus Fistula - microbiology</topic><topic>Carotid-Cavernous Sinus Fistula - surgery</topic><topic>Endarterectomy, Carotid - adverse effects</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Polyethylene Terephthalates - adverse effects</topic><topic>Postoperative Complications</topic><topic>Prosthesis-Related Infections - microbiology</topic><topic>Prosthesis-Related Infections - surgery</topic><topic>Reoperation</topic><topic>Retrospective Studies</topic><topic>Saphenous Vein - transplantation</topic><topic>Staphylococcal Infections - microbiology</topic><topic>Staphylococcus epidermidis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Borazjani, Boris H.</creatorcontrib><creatorcontrib>Wilson, Samuel E.</creatorcontrib><creatorcontrib>Fujitani, Roy M.</creatorcontrib><creatorcontrib>Gordon, Ian</creatorcontrib><creatorcontrib>Mueller, Mark</creatorcontrib><creatorcontrib>Williams, Russell A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><jtitle>Annals of vascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Borazjani, Boris H.</au><au>Wilson, Samuel E.</au><au>Fujitani, Roy M.</au><au>Gordon, Ian</au><au>Mueller, Mark</au><au>Williams, Russell A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Postoperative Complications of Carotid Patching: Pseudoaneurysm and Infection</atitle><jtitle>Annals of vascular surgery</jtitle><addtitle>Ann Vasc Surg</addtitle><date>2003-03-01</date><risdate>2003</risdate><volume>17</volume><issue>2</issue><spage>156</spage><epage>161</epage><pages>156-161</pages><issn>0890-5096</issn><eissn>1615-5947</eissn><coden>AVSUEV</coden><abstract>Patch angioplasty after carotid endarterectomy has been advocated to improve results by decreasing the incidence of recurrent stenosis and postoperative carotid thrombosis. Aneurysmal and infectious complications may be secondary to use of prosthetic materials in arterial reconstruction. We report four patients who developed late operative site complications related to carotid patching. All four of our patients had delayed pseudoaneurysms and three had infection related to the Dacron patch. In a typical case, a 57-year-old who had a right carotid endarterectomy in 1994 presented with a 1-month history of an enlarging right neck mass 7 years later. Imaging revealed a 6 × 4 cm pseudoaneurysm originating from an opening between the patch graft and the old endarterectomized carotid wall. Analysis of the literature disclosed an additional 45 patients who had pseudoaneurysms and/or infection related to carotid patching, most frequently with Dacron. We postulate that a low-grade
Staphylococcus epidermidis infection of the foreign body patch may be the etiology. Autogenous saphenous vein interposition graft and antimicrobials effective against gram-positive organisms corrected the pseudoaneurysm. Although the benefits of routine carotid patching may include a decrease in restenosis, this advantage must be weighed against the risk of late pseudoaneurysm and/or infection when a prosthetic patch is used to closed the endarterectomy site.</abstract><cop>Netherlands</cop><pub>Elsevier Inc</pub><pmid>12616349</pmid><doi>10.1007/s10016-001-0400-5</doi><tpages>6</tpages></addata></record> |
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subjects | Aged Angioplasty - adverse effects Blood Vessel Prosthesis - adverse effects Blood Vessel Prosthesis - microbiology Blood Vessel Prosthesis Implantation - methods Carotid Arteries - surgery Carotid-Cavernous Sinus Fistula - microbiology Carotid-Cavernous Sinus Fistula - surgery Endarterectomy, Carotid - adverse effects Humans Male Middle Aged Polyethylene Terephthalates - adverse effects Postoperative Complications Prosthesis-Related Infections - microbiology Prosthesis-Related Infections - surgery Reoperation Retrospective Studies Saphenous Vein - transplantation Staphylococcal Infections - microbiology Staphylococcus epidermidis |
title | Postoperative Complications of Carotid Patching: Pseudoaneurysm and Infection |
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