Neuroradiology

, Volume 54, Issue 12, pp 1347–1353

Factors affecting long-term restenosis after carotid stenting for carotid atherosclerotic disease

  • Jai Jai Shiva Shankar
  • Jingwen Zhang
  • Marlise dos Santos
  • Howard Lesiuk
  • Ravi Mohan
  • Cheemun Lum
Interventional Neuroradiology

Abstract

Introduction

The most significant factors leading to restenosis are yet to be described in the literature. The purpose of our study was to identify the incidence of restenosis in our patients with carotid artery stenting (CAS) for carotid atherosclerotic disease and to identify risk factors that are significantly responsible or related to the restenosis.

Methods

In this retrospective analysis of patients who underwent CAS for atherosclerotic disease between years 2002 and 2006, we studied various demographic, clinical, and medical factors, plaque characteristics, and technical aspects of CAS. All patients were followed up with carotid Doppler ultrasound at baseline (after 2 to 4 weeks of CAS) and then with Doppler ultrasound and clinically for various intervals of time. The restenosis was classified based on carotid Doppler ultrasound results. Clinically, restenosis was classified as symptomatic or asymptomatic. Pearson correlation coefficient was used to assess the statistical correlation of the different factors with the incidence of restenosis.

Results

We had a total of 105 patients, with a total of 204.6 patient-year follow-up (mean, 1.95 years; range, 0–7.3 years). The overall incidence of restenosis was 26.7 % (n = 28): mild, 7.6 % (n = 8); moderate, 10.5 % (asymptomatic, 11; symptomatic, 0); and severe, 8.6 % (asymptomatic, 5; symptomatic, 4). Overall, 14.3 % (n = 4) patients with restenosis were symptomatic and 7.1 % (n = 2) underwent retreatment. Post-stenting residual stenosis greater than either 30 % (p = 0.016) or 50 % (p = 0.05) were significant for long-term restenosis. Plaques longer than 20 mm were significantly related to restenosis (p < 0.001).

Conclusion

The most important factor to explain restenosis was the immediate post-CAS residual stenosis and length of the plaque.

Keywords

Carotid artery stenting Angioplasty Carotid artery stenosis Restenosis 

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Jai Jai Shiva Shankar
    • 1
  • Jingwen Zhang
    • 2
    • 3
  • Marlise dos Santos
    • 3
  • Howard Lesiuk
    • 4
  • Ravi Mohan
    • 3
  • Cheemun Lum
    • 3
  1. 1.Department of Diagnostic ImagingQE II HospitalHalifaxCanada
  2. 2.Department of RadiologyTianjin Medical University General HospitalTianjinChina
  3. 3.Department of Diagnostic ImagingThe Ottawa HospitalOttawaCanada
  4. 4.Department of NeurosurgeryThe Ottawa HospitalOttawaCanada

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