The purpose of the present study was to determine the acute clinical results associated with the performance of Dacron patch angioplasty during carotid endarterectomy, and to define the incidence of residual and recurrent carotid stenoses in patched arteries. Some 115 consecutive patients (mean age 68.0 years) underwent 119 primary carotid endarterectomy procedures in which the arteriotomy was repaired with a Dacron patch. The patients underwent duplex/occulopneumoplethysmography evaluation at 6 months after surgery, and annually thereafter. There was one (0.8%) operative death and two (1.7%) perioperative strokes. There were no immediate postoperative carotid thromboses. There were no wound or patch infections acutely, or in long-term follow-up. Thirteen patients (11%) were lost to follow-up; hence 106 arteries in 102 patients were followed for 1-65 (mean 17.8) months, including 66 arteries (62%) that have undergone serial OPG/duplex evaluation. The incidence of residual stenoses (within 3 months) was 4.5%, and that of recurrent stenoses 4.8%. The results of the study show Dacron carotid patch angioplasty to be associated with excellent clinical results, with a relatively low incidence of residual/recurrent carotid stenoses.