Long-term outcomes of open and endovascular treatment of recurrent carotid artery stenosis - a 16-year retrospective single centre case series

• Published in: VASA Vol. 49; no. 1; p. 23
• Main Authors: Ahmad, Wael, Deeb, Hiba, Otto, Christoph, Kalmykov, Egan L, Barkans, Arthurs, Kabbasch, Christoph, Sharkawy, Mohamed Ibrahim, Brunkwall, Jan Sigge
• Format: Journal Article
• Language: English
• Published: Switzerland 01-01-2020
• Subjects: Angioplasty; Carotid Stenosis; Endarterectomy, Carotid; Humans; Recurrence; Retrospective Studies; Risk Factors; Stents; Stroke; Time Factors; Treatment Outcome; Carotid stenosis; endarterectomy; angioplasty
• ISSN: 0301-1526
• DOI: 10.1024/0301-1526/a000824

The aim of this study is to evaluate perioperative as well as long-term outcomes in patients operated with carotid endarterectomy (CEA) or stenting (CAS) due to symptomatic or asymptomatic high-grade restenosis of the internal carotid artery (ICA).
In a retrospective analysis of our electronic database including 2980 patients who underwent carotid endarterectomy or stenting due to a symptomatic or asymptomatic high-grade stenosis of the ICA, between 2000 and 2016, we enrolled 111 patients with recurrent ICA stenosis.
An ipsilateral 2nd time restenosis (> 80 % in the asymptomatic and > 50 % in the symptomatic patients according to NASCET criteria) of ICA was detected in 13 patients (12 %); 3 of them were symptomatic. These patients were managed with either CEA (n = 5/38 %) or CAS (n = 8/62 %) with no perioperative stroke or death. The stroke-free survival rates at 2 and 8 years for CEA were 98 % and 98 % versus 100 % and 100 % for CAS respectively (P = .271). The type of the initial procedure (patch, CAS or interposition) did not play any significant role for the development of a 2nd time restenosis (P = .841).
: Redo-CEA/CAS seem to have similar results as primary procedures (as reported in the literature) with favorable periprocedural and long-term outcomes.