Patch surgery, specifically patch angioplasty, is a surgical procedure where an artery is opened, cleaned, and then widened using a patch of vein or prosthetic material. This reinforces and expands the treated section of the artery.
Here's a more detailed breakdown:
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The Problem: Arteries can become narrowed or blocked due to atherosclerosis (plaque buildup). This restricts blood flow and can lead to various health problems depending on the affected artery (e.g., peripheral artery disease if in the legs, heart attack if in the heart).
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The Procedure:
- Incision: The surgeon makes an incision to access the affected artery.
- Arteriotomy: The artery is carefully opened.
- Cleaning: The inside of the artery is cleaned to remove plaque and other debris.
- Patch Placement: A patch, made of either a section of a vein taken from elsewhere in the body (autologous vein graft) or a synthetic material (e.g., Dacron, PTFE), is sewn onto the opened artery. This effectively widens the artery.
- Closure: The incision is closed.
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Why Use a Patch? A patch prevents the artery from narrowing back down after cleaning. It provides structural support and creates a wider channel for blood flow.
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Types of Patches:
- Vein Patch: Using a vein from the patient's own body is often preferred as it reduces the risk of rejection. The saphenous vein in the leg is a common source.
- Prosthetic Patch: Synthetic materials like Dacron or PTFE (Teflon) can also be used. These are readily available and avoid the need for harvesting a vein.
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Indications: Patch surgery is typically used for:
- Severe arterial narrowing (stenosis).
- Arteries prone to collapse after angioplasty.
- Revision surgery after a previous angioplasty has failed.
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Advantages:
- Improved blood flow.
- Reduced risk of re-narrowing (restenosis) compared to angioplasty alone in some cases.
- Can relieve symptoms such as pain, numbness, and claudication (leg pain with exercise).
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Risks:
- Infection
- Bleeding
- Blood clots
- Graft failure
- Damage to surrounding tissues
In summary, patch angioplasty is a surgical technique used to widen narrowed arteries by opening the artery, cleaning it, and then sewing a patch over the opening to create a larger channel for blood flow.
