Synthetic versus biological patches for carotid endarterectomy.

Meta-analysisThe Cochrane database of systematic reviews· Aug 2026

Synthetic versus biological patches for carotid endarterectomy.

Kochaphan Phirom, Saritphat Orrapin, Thoetphum Benyakorn … Kittipan Rerkasem

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Vascular SurgeryMeta-analysisTreatmentQ1IF 5.3

Synthetic vs biological carotid patches show similar long-term stroke or death rates

Synthetic versus biological patches for carotid endarterectomy.

Kochaphan Phirom … Kittipan Rerkasem

The Cochrane database of systematic reviews · Aug 2026 · Q1 in General Medicine

Background

Extracranial carotid artery stenosis is a major cause of stroke.

Purpose

To assess the benefits and harms of synthetic patch materials and biological patch materials (autologous vein and bovine pericardium) used in carotid endarterectomy, particularly for pseudoaneurysm outcomes, stroke, and death.

Methods

To identify studies for inclusion in this updated Cochrane review, we searched Embase Ovid, CINAHL (EBSCO), PubMed, Scopus, the Cochrane Library, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform (International Clinical Trials Registry Platform) to 30 April 2025.

n = 4971 participants

Results

long-term stroke or death risk is about the same with either patch type

OR by subgroup · 95% CI

More results

Twelve of the included studies (with 2021 carotid endarterectomy procedures) contributed data to our main comparison of synthetic and biological patches.

Our concerns about study limitations also reduced our certainty about some outcomes.

“

Conclusion · 1 of 3

This 2026 updated review incorporates an expanded search strategy and a restructured analytical framework that groups patch materials into biological and synthetic categories.

Conclusion · 2 of 3

It also includes data from one newly identified trial (195 participants), together with extended follow-up data for some previously included trials.

Conclusion · 3 of 3

We believe that these changes have improved the completeness and methodological quality of our evidence synthesis.

Synthetic versus biological patches for carotid endarterectomy.

Synthetic versus biological patches for carotid endarterectomy.

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