AbstractObjectiveTo assess the effectiveness of cephalic vein patch (CVP) closure following carotid endarterectomy (CEA).Material and methodsWe reviewed 121 patients who underwent CEA using CVP closure. Patch-rupture, re-exploration, false aneurysm formation, re-stenosis requiring surgery, 30-day-mortality, donor site complications, stroke and TIA were noted. A small cohort of patients were reviewed at 5-years and rescanned.ResultsNo patient suffered patch rupture or re-stenosis requiring surgery. One patient developed false aneurysm at 1 year but at the time of repair the patch was found to be intact. There were two cardiac deaths. Three patients suffered strokes of whom two made a full recovery. There were three cases of TIA. All wrist wounds healed primarily without complications. None of the 10 patients recalled for scanning at 5 years showed re-stenosis or late aneurysmal dilatation at the site of surgery.ConclusionCephalic-vein can be harvested at the wrist without donor site complications and our experience shows it to be a convenient and safe means of closure following CEA. Compared to prosthetics it is cheaper and less susceptible to bacterial contamination. The use of CVP preserves leg veins for future cardio-vascular interventions. Long term function of CVP appears satisfactory.