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Editor-in-Chief Ufuk Demirkılıç Frequency Quarterly Abbreviation Turk J Vasc Surg Publisher Turkish National Vascular and Endovascular Surgery Society ISSN 2667-4947 E-ISSN 2667-5080
Turkish Journal of Vascular Surgery 2006 , Vol 15 , Issue 3
EXTERNAL JUGULAR VEIN "SLEEVEPATCH" AS AN ALTERNATİVE AUTOLOGOUS PATCH MATERIAL IN CAROTİD ENDARTERECTOMY
Erdal ASLIM1, Hakkı Tankut AKAY1, Süleyman ÖZKAN1, Bahadır GÜLTEKİN1, Salih ÖZÇOBANOĞLU1, Sait AŞLAMACI1
1Başkent Üniversitesi Tıp Fakültesi Kalp ve Damar Cerrahisi Anabilim Dalı, Ankara Background: In carotid artery surgery it is accepted that patchplasty prevents perioperative and postoperative restenosis and as a result of this it reduces the incidence of ipsilateral stroke. In the present time synthetic patch materials (PTFE, Dacron) and autologous patch materials (Saphenous and juguler veins) are used. In this study we tried to investigate the feasibility of double- layered everted external jugular vein as an alternative autologous patch material in carotid endarterectomy and patch plasty operations. We also searched the impact of this patch on mortality and morbidity.

Methods: Between June 2004 and March 2005 external jugular vein was used as a patch material in 11 patients undergoing carotid artery endarterectomy with cervical block anesthesia. External jugular veins were dilated and everted after harvesting.The mean carotid clamp and total operation times were 30.5(27-36) minutes and 113.6(90-120) minutes respectively.

Results: There was not any edema, hematoma, hemorraghia and infection. The mean intensive care and total hospital stay times were 1.0 (0-11) and 3.1 (2-11) days respectively. There was not any stroke in any patients. There was an acute respiratory failure in a patient with chronic obstructive lung disease which was followed by a myocardial infarction abd ventricular fibrillation in the fifth postoperative day.

Conclusion: We believe that double-layered everted external jugular vein is safe as saphenous vein graft in high-risk patients undergoing carotis endarterectomy with regional anesthesia for preventing posoperative restenosis and ipsilateral stroke. The incidences of local complications (edema, hematoma, hemorraghia and infection) are significantly low when compared with synthetic patch materials. There is no need for a second incision for graft harvesting when compared with operations by saphenous vein grafts. The incidence of aneurymatic dilatation of the external jugular vein grafts is also lower when compared with saphenous grafts. As a result we conclude that external jugular vein graft is a safe, cheap graft with low incidence of complications. (Turkish J Vasc Surg 2006;15(3):21-24). Keywords : Carotid Endarterectomy, Sleevepatch, Jugular vein

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