Comparative analysis of the biaxial mechanical behavior of carotid. The role of polyester patch angioplasty in carotid endarterectomy. Hemashield platinum finesse surgical fabrics, meshes. Recently, we reported a satisfactory hemostasis time using the newly introduced hemostatic ptfe patch the acuseal patch by w. Backed by more than 45 years of experience in textile graft technology, the hemashield patch is the most used fabric for carotid endartere tomy, providing reliable and. Comparative analysis of the biaxial mechanical behavior of. Dec 08, 2011 patch angioplasty is the most common technique used for the performance of carotid endarterectomy. Flaherty, bs, and zachary aburahma, charleston, wva backgroundpurpose. Use of a small intestine submucosa extracellular matrix patch.
Oct 28, 2015 primary closure versus patch angioplasty and selective versus routine shunting during ceas have their respective risks and benefits, and patient outcomes should be used to evaluate the benefits and risks associated with different surgical techniques 1214, including rate of restenosis, infection, myocardial infarction mi, urinary tract. Patch angioplasty is commonly performed after carotid endarterectomy. The most used fabric for carotid endarterectomy, providing reliable and safe performance. Albosure polyester vascular patch is a knitted polyesterfabric, impregnated with bovine collagen and contains glycerol as softening agent. Patch, pledget and intracardiac, petp, ptfe, polypropylene product code dsy. Two perioperative carotid thromboses were noted with finesse patching vs none with acuseal patching p. Goretex vs finesse hemashield patching during carotid endarterectomy. Hemashield gold knitted double velour vascular grafts from. We proceeded to perform a patch angioplasty of three vessels by sewing a hemashield finesse patch to the vessel edges using 60 prolene suture placed in the running fashion. Additionally, the number of patients with 50% stenosis at 30day duplex exam was reduced from 12% in the previous series to 4% using the finesse patch. Hemashield platinum finesse ultrathin knitted cardiovascular patch proprietary hemashield collagen impregnation provides uniform tissue ingrowth.
Methods one hundred and fiftyseven ceas were randomized into two groups, 84 with the acusealptfe patch and 73 with the finesse patch. Prospective randomized trial of acuseal goretex vs finesse hemashield patching during carotid endarterectomy longterm outcome. Several studies have reported that carotid endarterectomy cea with patch angioplasty produces superior results compared with primary. Conventional polytetrafluoroethylene ptfe patching has been shown to have results comparable to autogenous vein patching. Prospective randomized trial of carotid endarterectomy with primary closure and patch angioplasty with saphenous vein. Hemodynamically motivated choice of patch angioplasty for the. Hemacarotid by gore and hemashield by boston scientific patches. A singlecenter retrospective study with 5 and 10year. Hemashield platinum finesse surgical fabrics, meshes, and. A large number of patching materials are available for use while new materials are being continuously developed. Several studies have reported that carotid endarterectomy with patch angioplasty is superior to primary closure. Hemashield platinum finesse surgical fabrics, meshes, and tapes experience makes a material difference hemashield platinum finesse ultrathin knitted cardiovascular patch sealed to a higher standard.
The hemashield patch is the most used fabric for carotid endarterectomy, providing reliable and safe performance. Class 2 device recall hemashield finesse ultrathin knitted. The hyperperfusion state was determined based on the increase in transcranial doppler or. The patch angioplasty with hemashield woven double velour finesse was performed with 60 prolene ethicon inc. The combined early morbidity rate tia, stroke, and or50% restenosis or thrombosis was 2% for the acuseal patch vs 8% for the finesse patch p. Recently, we reported a satisfactory hemostasis time using the new hemostatic ptfe patch acuseal by gore.
Computational fluid dynamics of carotid arteries after. Jan 31, 2017 in icd10pcs two codes are required to appropriately report a carotid endarterectomy with patch graft. Asv or synthetic material for patch angioplasty significantly influences the results after carotid. The use of hemashield patch angioplasty is relatively new in my. The miller banding procedure is an effective method for. Maquet offers conve nient and innovative clinical solutions for cardiothoracic and abdominal aneurysms and peripheral vascular therapy options including a line of surgical fabrics, meshes and tapes designed for a range of different clinical applications.
Prospective randomized trial of acuseal goretex versus. The hemashield platinum finesse ultrathin knitted cardiovascular patch promotes exceptional handling, hemostasis, and healing during vascular or cardiac patching procedures. Cea with patch angioplasty produces superior results compared with primary closure. The acuseal ptfe patch was comparable to the conventional ptfe for restenosis, with no patients. Hemashield patch is the most used fabric for carotid endarterectomy, providing reliable and safe performance. Methodsthis study includes 200 ceas randomized into 100 with polytetrafluoroethylene ptfe acuseal patch and 100 with hemashield finesse patch. The fabric is recommended for use in patients requiring systemic heparinization prior to, or during, surgery. Several studies have reported that carotid endarterectomy cea with patch angioplasty produces superior results compared with primary closure. In the last few years, a few authors, particularly surgeons in europe, have reported using the finesse hemashield with satisfactory results.
Rcts were included if they compared carotid patch angioplasty with. The hemashield platinum finesse patch promotes exceptional handling, hemostasis and healing during vascular or cardiac patching procedures. Download finesse hemashield patch free software internettoo. In summary, all acuseal ptfe patches and finesse hemashield patches. The result of patch angioplasty using hemashield finesse and goretex cardiovascular patch is considered excellent. Edwards lifesciences, the longestablished bovine tissue technology leader, provides the edwards bovine pericardial patch designed for a variety of applications including. Selective patch angioplasty and intraoperative shunting in. The purpose of this study is to determine if patch angioplasty closure alters velocities just distal to cea and to define the optimal velocities for detecting. The hemashield platinum finesse ultrathin knitted cardiovascular patch is used for cardiac and vascular patch grafting. Stretching of the band was performed at a rate of 0. Carotid endarterectomy with patch graft angioplasty. Hemashield finesse ultrathin knitted cardiovascular patch indicated for cardiac and vascular patch grafting. Hemashield gold knitted double velour vascular grafts are collagenimpregnated and come in straight, bifurcated, or axillobifemoral options of varying lengths. A prospective, randomized study of saphenous vein patching versus.
Aug 08, 2004 with 50% improved porosity over the companys existing hemashield finesse patch, the hemashield platinum finesse patch provides excellent hemostasis, or a reduced amount of bleeding after closing the incision. Tex versus hemashieldfinesse patching during carotid endarterectomy. The objective of this study was to investigate biomechanics of the carotid artery ca repaired with patch angioplasty, study the influence of. Hemashield platinum finesse ultrathin knitted cardiovascular patch. Patches of different types for carotid patch angioplasty rerkasem k, rothwell pm. The patch is tapered and pretrimmed for greater efficiency and it conforms to the host vessel for improved handling. Twentyeight patients underwent cea with the hemashield finesse, and six patients with the goretex patches. Goretex vs finesse hemashield patching during carotid. Intermediateterm outcome of carotid endarterectomy with bovine. Direct angiography or indocyanine green video angiography was performed after patch angioplasty. Prospective randomized trial of acuseal gore tex versus. This study examined the longterm clinical outcome and incidence of restenosis after carotid endarterectomy using the new acuseal goretex patching vs hemashield finesse boston scientific corp, natick, mass patching.
The left side of the carotid artery was treated in every patient. Apr 11, 2017 the hemashield platinum finesse ultra thin knitted cardiovascular patch promotes exceptional handling, hemostasis, and healing during vascular or cardiac patching procedures. This study is the first prospective randomized trial comparing the acuseal ptfe patch versus the hemashield finesse patch. Controversy surrounds the selection of the patch material, with. A large number of materials are available, but little is known to aid the surgeon in choosing a patch while caring for a patient with carotid disease. Ultrathin fabric designed to improve handling characteristics. The albosure polyester vascular patch is indicated for. This is a change from icd9cm procedural coding as the patch graft was included in the endarterectomy code.
Proposed duplex velocity criteria for carotid restenosis. Synthetic materials used for carotid patch angioplasty 2011. The hemashieldpatch is the most used fabric for carotid endarterectomy, providing reliable and safe performance. Hemashield patch angioplasty patch angioplasty is performed to prevent recurrent stenosis after carotid endarterectomy cea. Patch closure improves results with carotid endarterectomy.
Hemashield platinum finesse knitted cardiovascular patch. The mean hemostasis time for the acuseal and finesse patches was 5. Aug 25, 2012 patch angioplasty is the most common technique used for the performance of carotid endarterectomy. Hemashield platinum finesse knitted cardiovascular patch ams.
In addition, outcomes of recent generations of various prosthetic materials show no differences when compared to autologous vein patches. The rationale for patchgraft angioplasty after carotid endarterectomy. Augmenting the patients own pericardium to assist in closure following openheart surgery. Aburahma af, robinson pa, saiedy s, kahn jh, boland jp. However, the finesse patch produced better results than those previously achieved with the conventional hemashield patch 4% vs 12% respectively. Patch angioplasty was associated with a reduction in risk for stroke of any type p. This study is the first prospective randomized trial comparing the acuseal patch with the hp finesse patch. Multiple studies have established that patch angioplasty following. Synthetic patch angioplasty proves useful in carotid. The combined early morbidity rate tia, stroke, and. Randomized prospective trials and metaanalyses have documented improved rates of perioperative and longterm stroke prevention as well as reduced rates of restenosis for patches compared with primary closure of the arteriotomy.
This study included 2 patients who had undergone patch cea with hemashield finesse boston scientific meditech, wayne, new jersey and 2 patients who had undergone cas with a selfexpandable, opencelltype precise stent cordis, miami lakes, florida. Patch angioplasty is commonly performed hemashield finesse patch group included reconstruction with either a vein patch or an interposition graft. Hemashield finesse knitted cardiovascular patch k962342 device description. Jul 06, 2018 accessgudid hemashield 00384401017950 hemashield platinum finesse ultrathin knitted cardiovascular patch. Prospective randomized comparison of acuseal goretex. The patient underwent a repeated right carotid endarterectomy using a small intestine submucosa extracellular matrix patch for closure of the arteriotomy. Maquet, 019579p, maquet hemashield platinum finesse. Given the unique biologic properties of the small intestine submucosa patch and the technical advantages associated with its use for patch angioplasty, further studies to define its efficacy. Backed by more than 45 years of experience in textile graft technology, the hemashield patch is the most used fabric for carotid endartere tomy, providing reliable and safe performance. Citeseerx notesprospective randomized comparison of acuseal. Patch angioplasty during carotid endarterectomy cea may reduce the risk for perioperative or late carotid artery recurrent stenosis and subsequent ischemic stroke. Prospective randomized trial of acuseal goretex vs finesse.