Carotid angioplasty and stenting versus redo endarterectomy for recurrent stenosis

Am J Surg. 2007 Mar;193(3):356-9; discussion 359. doi: 10.1016/j.amjsurg.2006.09.020.

Abstract

Background: Carotid angioplasty and stent (CAS) is an alternative to redo carotid endarterectomy (RCEA) for recurrent carotid stenosis (RCS). The purpose of this study was to evaluate the outcomes of CAS in the treatment of RCS.

Methods: In an 8-year period, all patients presenting for treatment of RCS were followed-up prospectively. Logistic regression analysis was performed to identify variables associated with unfavorable outcomes.

Results: There were 45 CAS and 46 RCEA procedures performed in 75 patients. One patient in each group suffered a stroke. There were no deaths. The hospital length of stay was significantly shorter for CAS. Secondary recurrence was higher after RCEA (14% vs 6.1%) and failure to take beta-blockers was an independent predictor for multiple recurrences.

Conclusions: CAS is a safe and effective method to treat patients with RCS and may become the procedure of choice for this disease.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Aged
  • Angioplasty / methods*
  • Carotid Stenosis / surgery*
  • Endarterectomy, Carotid / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Prospective Studies
  • Recurrence
  • Reoperation / methods
  • Risk Factors
  • Stents*
  • Treatment Outcome