INTRODUCTION: Restenosis after carotid endarterectomy (CEA) has been described in 8-19% of patients, 14-23% of whom become symptomatic. This study analyzes our experience with carotid artery stenting (CAS) for post-CEA recurrent stenoses. METHOD: Retrospective database and case-note review. RESULTS: Between January 2000 and September 2008, a total of 27 patients (15 symptomatic) with hemodynamically significant internal carotid artery post-CEA restenosis underwent CAS. Median stenosis of target vessels was 90% (range 75-95%). There was one periprocedural death (3.7%); no others occurred during the median 34-month follow-up (range 0.1-84 months). There was one late transient ischemic attack 12 months after CAS that was not associated with in-stent restenosis. One 90% restenosis and one occlusion were detected during follow-up at 38 and 57 months after CAS. The remaining patients had no evidence of further restenosis and remained free from cerebrovascular symptoms. CONCLUSION: CAS offers a feasible option for the management of carefully selected patients with symptomatic and asymptomatic restenosis after CEA.
INTRODUCTION:Restenosis after carotid endarterectomy (CEA) has been described in 8-19% of patients, 14-23% of whom become symptomatic. This study analyzes our experience with carotid artery stenting (CAS) for post-CEA recurrent stenoses. METHOD: Retrospective database and case-note review. RESULTS: Between January 2000 and September 2008, a total of 27 patients (15 symptomatic) with hemodynamically significant internal carotid artery post-CEA restenosis underwent CAS. Median stenosis of target vessels was 90% (range 75-95%). There was one periprocedural death (3.7%); no others occurred during the median 34-month follow-up (range 0.1-84 months). There was one late transient ischemic attack 12 months after CAS that was not associated with in-stent restenosis. One 90% restenosis and one occlusion were detected during follow-up at 38 and 57 months after CAS. The remaining patients had no evidence of further restenosis and remained free from cerebrovascular symptoms. CONCLUSION:CAS offers a feasible option for the management of carefully selected patients with symptomatic and asymptomatic restenosis after CEA.
Authors: Albeir Y Mousa; Ali F AbuRahma; Joseph Bozzay; Mike Broce; Maher Kali; Michael Yacoub; Patrick Stone; Mark C Bates Journal: J Endovasc Ther Date: 2015-04-15 Impact factor: 3.487