title: Long-term follow-up of patients operated on for recurrent carotid stenosis.
abstract: We reviewed our experience with 29 operations for recurrent carotid stenosis in 27 patients who underwent both their primary carotid endarterectomy and their reoperations at our institution. These 27 patients represent 4% of the 667 patients who underwent primary carotid endarterectomies at our institution and who are included in our carotid follow-up registry. Reoperation was prompted by recurrent symptoms in 19/29 (65.5%) cases. Comparison of long-term stroke prevention in those patients who did (84% at 5 years, 78.6% at 10 years) and did not (90.3% at 5 years, 83.6% at 10 years) develop recurrent stenosis requiring reoperation revealed no statistically significant difference (p = 0.48) when measured from the time of primary operation. The perioperative stroke and death rates for reoperation (3.4% and 0%) were acceptable. We conclude that with our acceptably low perioperative stroke morbidity (3.4%), surgery for recurrent carotid stenosis in symptomatic patients or in asymptomatic patients with high-grade (greater than or equal to 75%) stenosis maintains the durable stroke prevention offered by primary carotid endarterectomy.
authors.affiliation: New England Medical Center, Tufts University School of Medicine, Department of Surgery, Boston, MA.
authors.forename: R S
authors.initials: RS
authors.lastname: Nitzberg
authors.forename: W C
authors.initials: WC
authors.lastname: Mackey
authors.forename: E
authors.initials: E
authors.lastname: Prendiville
authors.forename: E
authors.initials: E
authors.lastname: Foster
authors.forename: W
authors.initials: W
authors.lastname: Kastrinakis
authors.forename: M
authors.initials: M
authors.lastname: Belkin
authors.forename: T F
authors.initials: TF
authors.lastname: O'Donnell
authors.forename: A D
authors.initials: AD
authors.lastname: Callow
mesh_terms: D002339:Carotid Arteries / Q000473:pathology / Q000601:surgery; D002340:Carotid Artery Diseases / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D002561:Cerebrovascular Disorders / Q000517:prevention & control; D003251:Constriction, Pathologic / Q000453:epidemiology / Q000401:mortality / Q000601:surgery; D004691:Endarterectomy / Q000401:mortality; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D015993:Life Tables; D012008:Recurrence; D012086:Reoperation / Q000401:mortality; D012737:Sex Factors; D013997:Time Factors