Evaluation of Everted External Jugular Vein for Patch Angioplasty

Abstract

Patch angioplasty of the carotid artery is believed to prevent iatrogenic narrowing, as well as reduce potential thrombosis and minimize the incidence of recurrent stenosis. Vascular surgeons prefer autogenous vein, although polytetrafluorothylene and Dacron have been utilized successfully. Saphenous vein harvested from the groin is probably the safest owing to its thickness. External and internal jugular vein have both been used because of their convenience and proven efficacy. These veins are, however, thin, and patch failure and subsequent rupture have been recorded. Recently advocates of this patch have everted the vein and employed double-layer closure for carotid patch angioplasty for additional strength. The authors constructed and examined everted and singlelayer external jugular vein patches placed for five days in canine carotid and femoral arteries. Each vein patch demonstrated necrosis of the intimal layer with an inflammatory and fibrous rebuilding process identified in the media and adventitia. The single-layer patch was identical in characteristics; however, the double-layer patch possessed a dual thickness of the above-mentioned morphologic changes.