Use of (Xenosure) bovine patches in vascular reconstruction

vascular surgery

drs. D.J. Liesker
dr. B.R. Saleem

Nature of the research:
retrospective cohort study

Fields of study:

Background / introduction
Carotid endarterectomy (CEA) with patch angioplasty is a common technique to reduce the risk of stroke caused by carotid artery stenosis. Different patch materials are used, including autologous vein, bovine pericardium, and synthetic material (polytetrafluoroethylene (PTFE), Dacron, polyurethane, and polyester). Following a meta-analysis of RCTs of Orrapin et al., bovine patch may decrease the incidence of fatal stroke, infection, and mortality compared to other graft materials.1 Furthermore, the use of bovine patch prevents an additional incision (and associated complications) to obtain autologous vein. Moreover, the material is easy to suture and useful in cases of challenging anatomy because of elastic properties. The potential protective property of bovine pericardial patches against infection is also shown by Anibueze et al. This study showed excellent short-term results after reconstruction of a mycotic aortic aneurysm and vascular graft infection with bovine pericardium.2 However, long-term results are missing. In this study we will evaluate the use of bovine patch for closure during CEA and compare these biological xenografts with alternatives
Research question / problem definition
- What is the long term outcome of carotid endarterectomy with bovine patch closure in comparison with Dacron, PTFE, and autologous vein?
- Is there a difference in outcome (mortality and morbidity) in patients ≥80 years in comparison with patients <80 years of age?
All patients that underwent carotid endarterectomy over the last 10 years will be included. Data will be retrieved from (electronic) patient records.
1 Orrapin S, Benyakorn T, Howard DP, Siribumrungwong B, Rerkasem K. Patches of different types for carotid patch angioplasty. Cochrane Database Syst Rev 2021;2021(2). Doi: 10.1002/14651858.CD000071.pub4.

2 Anibueze C, Sankaran V, Sadat U, Tan K, Wilson YG, Brightwell RE, et al. Neoaortic Xenoprosthetic Grafts for Treatment of Mycotic Aneurysms and Infected Aortic Grafts. Ann Vasc Surg 2017;44:419.e1-419.e12. Doi: 10.1016/j.avsg.2017.02.021.
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