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Neuroradiology

, Volume 49, Issue 4, pp 357–364 | Cite as

Carotid angioplasty and stent placement for restenosis after endarterectomy

  • Yasha Kadkhodayan
  • Christopher J. MoranEmail author
  • Colin P. Derdeyn
  • DeWitte T. CrossIII
Interventional Neuroradiology

Abstract

Introduction

Recurrent carotid stenosis following endarterectomy is a common complication, and reoperation may be associated with increased morbidity. The goal of this study was to determine the procedural safety and long-term complication rates of carotid angioplasty and stenting for recurrent stenosis.

Methods

Of 248 consecutive carotid angioplasty and/or stenting procedures performed at our institution between March 1996 and November 2005, 83 procedures for recurrent stenosis following endarterectomy were performed in 75 patients (mean age 68 years; 43 men, 32 women) without cerebral protection devices. The patients’ medical records were retrospectively reviewed for vascular imaging reports and available clinical follow-up. Procedural and long-term complication rates were calculated.

Results

Recurrent stenosis was reduced from a mean of 80.6% to no significant stenosis in 82 of 83 procedures. The procedural stroke rate was 3 out of 83 procedures (3.6%). The procedural transient ischemic attack (TIA) rate was 2 out of 83 procedures (2.4%). Mean follow-up was 22.4 months (range 0.1 to 86.7 months) with at least 6 months follow-up for 54 of 83 procedures (65%). There were five TIAs and no strokes on follow-up (new TIAs at 25.5 and 43.4 months; recurrent TIAs at 1, 11.1, and 12 months, all with normal angiograms). The composite 30-day stroke, myocardial infarction, or death rate was 5 of 83 procedures (6.0%).

Conclusion

In this series, angioplasty and stenting were effective in relieving stenosis secondary to recurrent carotid disease after endarterectomy, and have low rates of ischemic complications.

Keywords

Carotid disease Atherosclerosis Stenting Stroke Carotid endarterectomy 

Notes

Conflict of interest statement

We declare that we have no conflict of interest.

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Yasha Kadkhodayan
    • 1
  • Christopher J. Moran
    • 1
    • 2
    Email author
  • Colin P. Derdeyn
    • 1
    • 2
    • 3
  • DeWitte T. CrossIII
    • 1
    • 2
  1. 1.Interventional Neuroradiology, Mallinckrodt Institute of RadiologyWashington University School of MedicineSt. LouisUSA
  2. 2.Department of Neurological SurgeryWashington University School of MedicineSt. LouisUSA
  3. 3.Department of NeurologyWashington University School of MedicineSt. LouisUSA

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