The incidence of recurrent carotid stenosis after carotid endarterectomy and its relationship to neurological events.

We have studied the incidence of postoperative recurrent stenosis and occlusion in 286 patients, following 320 carotid endarterectomies, all of whom were commenced on low dose aspirin postoperatively. Two hundred and thirty patients (242 procedures) were examined clinically and by duplex scanning on at least two occasions at a minimum of six months apart. The crude incidence of significant recurrent carotid disease was 9.1% (22 out of 242). Seven of 22 vessels had recurrent disease detected within 24 months of operation, representing a crude incidence of 2.9% and a cumulative incidence of 4.2% at two years. The remainder developed recurrent disease after this time. Multivariate analysis of risk factors for recurrent carotid disease following carotid endarterectomy showed that a history of hypertension was significant (p = 0.001). The incidence of ipsilateral neurological events was 7.4% and was related to the presence of recurrent carotid disease (p less than 0.001).