Intraoperative evaluation of PTFE, Dacron and autogenous vein as carotid patch materials

Abstract

Between 1983 and 1986 we prospectively randomized 71 consecutive carotid endarterectomy patients to receive patch closure with one of three materials. Autogenous saphenous vein was used in 18 cases, Dacron velour (Sauvage Filamentous) in 30 cases, and PTFE (Gore-Tex CV patch) was used in 23 cases. Blood loss in the excess of 300 ml was seen in 43% (10/23) of the PTFE group in contrast to only 22% (5/23) of the ASV group and 17% (4/23) of the Dacron group. Persistent suture hole bleeding requiring the use of a significantly larger amount of oxidized cellulose (p less than .001) was noted in the PTFE group. Operating time from clamp release to end of procedure was significantly greater in the PTFE group (p less than .05), reflecting the delay associated with suture hole bleeding. In addition, the handling characteristics of PTFE were inferior to those of Dacron or autogenous saphenous vein. Needle penetration was relatively difficult. PTFE was thicker, less flexible, and a less satisfactory match to the endarterectomized carotid than the other materials.