Patch corrugation on duplex ultrasonography may be an early warning of prosthetic patch infection.

Four of 10 patients presenting with prosthetic patch infection after carotid endarterectomy (CEA) were noted to have Duplex evidence of 'corrugation' of the prosthetic patch, without false aneurysm formation. In three, corrugation preceded diagnosis of overt patch infection by up to 11 months. In the fourth patient, awareness of the potential significance of patch corrugation enabled timely treatment of an otherwise unrecognized patch infection. Even if other imaging modalities are normal, the presence of patch corrugation on Duplex should prompt the surgeon to (at least) consider the possibility of patch infection.