[Treatment of restenosis].
Carotid restenosis after endarterectomy is observed in up to 24.1% of patients with long-term follow up. Indication for reintervention in asymptomatic patients however should be reserved for greater than 80% stenosis. Treatment options include repeat surgical reconstruction as well as intraoperative or percutaneous balloon angioplasty +/- stenting. We compared our past experience with 66 operative reconstructions in 64 patients with a recent series of 60 patients who underwent intraoperative balloon-dilatation and stenting. After conventional surgery 2 patients (3.1%) suffered a permanent neurological deficit, one patient developed a TIA (1.5%). After intraoperative dilation and stenting 8 patients (13.3%) suffered a stroke; 2 patients died after surgery (one stroke, one myocardial infarction) (mortality 3.3%). When compared to conventional operative repair intraoperative carotid balloon angioplasty and stenting of restenosis is complicated by a substantial increase in morbidity and mortality and cannot be recommended as routine therapy.
Raithel
D
D
Klinik für Gefässchirurgie, Klinikum Nürnberg-Süd. dieter.raithel@rzmail.uni-erlangen.de
Schunn
C
C
Hetzel
G
G
Ritter
W
W
D015901:Angiography, Digital Subtraction; D000800:Angioplasty, Balloon; D019917:Blood Vessel Prosthesis Implantation; D016893:Carotid Stenosis / Q000175:diagnosis / Q000601:surgery* / Q000628:therapy*; D016894:Endarterectomy, Carotid / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D011138:Polytetrafluoroethylene; D012008:Recurrence; D012086:Reoperation; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D011138:Polytetrafluoroethylene