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Purpose: This study retrospectively reviewed the experience with expanded polytetrafluoroethylene (ePTFE) patches for carotid endarterectomy in 924 consecutive procedures (753 patients) during a 17-year period. Methods: The records of all patients who underwent ePTFE patch angioplasty for carotid artery stenosis performed by one surgeon were reviewed. The criterion for surgery was stenosis of 80% or greater.

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Follow-up by use of noninvasive methods was done by 6 months after operation the first year and annually thereafter. Recurrent stenosis was confirmed with angiography. Helper Converthelper. Life-table analysis was used to estimate the risk of restenosis. Results: Early morbidity and mortality included six deaths (0.6%), seven nonfatal strokes (0.9%), and 19 hemorrhages.

Two postoperative infections occurred. There were no important aneurysmal dilations and no late hemorrhages. With a mean follow-up of 41.4 months (range 0 to 197), recurrent stenosis necessitating reoperation developed in 28 patients (3.7%). There were two late strokes.

Life-table analysis indicated a 89% probability of freedom from stenosis at 120 months. Conclusions: In cases in which the decision to perform patch angioplasty is made at surgery, an ePTFE patch is an excellent alternative to autogenous saphenous vein, with a low rate of recurrences requiring operation and acceptable rates of perioperative and postoperative morbidity and mortality. (J V ASC S URG 1995;22:724-31.). Carotid endarterectomy has been alternately regarded with caution, enthusiasm, distrust, and then renewed enthusiasm after the publication of the North American Symptomatic Carotid Endarterectomy Trial (NASCET). X 1 North American Symptomatic Carotid Endarterectomy Trial Collaborators. Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. 1991; 325: 445–453 More recent results from the Asymptomatic Carotid Atherosclerosis Study (ACAS) x 2 Fisher, M, Martin, A, Cosgrove, M, and Norris, JW.

Texas Motorcycle Program. The NASCET-ACAS plaque project. Remove Duplicate Files Software. 1993; 24: I24–I25 have further confirmed the merit of carotid endarterectomy in the prevention of stroke. Debate continues, however, about the value of patch angioplasty for preventing recurrent stenosis and postoperative thrombosis and the benefits of saphenous vein versus synthetic patches.