Carotid Endarterectomy with Patch Angioplasty: A Case of Postoperative Infection and Literature Review

John Muhonen II*, Christopher Esper, Jon Henwood and Patrick Downs

Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, USA

^*Correspondance to: John E Muhonen II 

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Abstract:

Infections are a rare but recognized complication of carotid endarterectomy with patch angioplasty.
Its prevalence is approximately 1% of all synthetic patch angioplasties and may present with a
variety of symptoms including local swelling, pain, hemorrhage, and/or neurological deficit. The
presentation of suspected infection can be early in the post-operative period or delayed by years. The
underlying micro-organism tends to direct, at least in part, the timing of presentation. Patients with
suspected infections require urgent vascular surgery evaluation. We present a case of a patient with
a suspected infected Dacron graft patch angioplasty four weeks post carotid endarterectomy. The
patient presented with pain, swelling, and erythema without signs of systemic infection. This patient
was managed with explanation of the Dacron graft and vein patch with extended antibiotic therapy.
We additionally performed a thorough review of all current literature and case series to identify
symptomatology, infectious etiologies, recommended antibiotic regiments and length of therapy,
and evaluated multiple surgical treatment modalities.

Keywords:

Carotid endarterectomy infection; Dacron patch; Management

Cite the Article:

John Muhonen II, Esper C, Henwood J, Downs P. Carotid Endarterectomy with Patch Angioplasty: A Case of Postoperative Infection and Literature Review. World J Surg Surgical Res. 2020; 3: 1265..