The problem of recurrent stenosis following carotid endarterectomy.
From 1977 to 1985, 306 consecutive patients underwent carotid endarterectomy by a single surgeon. The post-operative stroke and death rates were 1.3% and 2.6%. Of the 184 patients with follow-up duplex scanning, 24 (13%) had a recurrent stenosis of 50% or greater. Of 15 possible risk factors studied to assess a possible relationship with recurrent stenosis, four were definitely associated and a fifth probably implicated. The four definitely associated risk factors for recurrent stenosis were an age of 70 years or older (p = 0.0025), female gender (p = 0.0001), ulcerated lesions (p = 0.013), and asymptomatic lesions (p = 0.041). The fifth risk factor that may play a role (though not reaching statistical significance) was combined carotid endarterectomy and myocardial revascularization (p = 0.066). In these patients, we recommend using vein patch angioplasty to reduce the recurrence rate.
Maki
H S
HS
Kruger
R A
RA
Kuehner
M E
ME
D000368:Aged; D001157:Arterial Occlusive Diseases / Q000601:surgery; D002340:Carotid Artery Diseases / Q000601:surgery*; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D008297:Male; D012008:Recurrence; D012307:Risk Factors