Redo endarterectomy for recurrent carotid artery stenosis.
From a registry of 2406 carotid endarterectomies performed on 1818 patients over a 19-year period, 29 patients (1.6%) underwent reoperations for recurrent stenosis. Reoperations were performed for symptomatic stenosis for 23 and asymptomatic greater than 80% stenosis for six patients. Compared to the entire series, there was no difference in the incidence of restenosis for men and women. The pathologic findings were myointimal hyperplasia in 27%, atherosclerosis in 53%, thrombus with vessel dilatation in 17% and extrinsic scar in 3%. Redo endarterectomy with patch angioplasty was used for reconstruction in 27 patients and patch angioplasty alone in two. There were no operative deaths or strokes. Late follow-up (mean 50 months) revealed only one stroke and six other deaths. Although 21 (75%) were alive and stroke-free, follow-up studies suggest a high incidence (21%) of tertiary lesions among patients who have undergone redo endarterectomy for recurrent stenosis.
Gagne
P J
PJ
Department of Surgery, New York University Medical Center, N.Y.
Riles
T S
TS
Imparato
A M
AM
Lamparello
P J
PJ
Giangola
G
G
Landis
R M
RM
D000368:Aged; D002339:Carotid Arteries / Q000601:surgery*; D002340:Carotid Artery Diseases / Q000453:epidemiology / Q000601:surgery*; D003251:Constriction, Pathologic / Q000453:epidemiology / Q000601:surgery; D004691:Endarterectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015993:Life Tables; D008297:Male; D012042:Registries; D012086:Reoperation; D012307:Risk Factors