Single-center experience with carotid stent restenosis.
OBJECTIVE
To report the angiographic morphology of carotid stent restenosis and the possible therapies based on data from a single-center experience.


METHODS
In a 45-month period, 279 patients (196 men; mean age 70 +/- 9 years, range 50-89) underwent successful Wallstent placement in 303 stenotic internal carotid arteries (ICA). Patients were followed with duplex sonography; angiography was used to confirm any significant (> or =70%) recurrent lesions detected on the ultrasound scan. Further balloon dilation with or without stent placement was undertaken. RESULTS; Over a median 12-month follow-up (interquartile range 6-24), there were 9 (3.0%) carotid stent restenoses found, all within 12 months after stent placement. Two types of restenosis were differentiated. In the more common form, "in-stent" stenoses (n = 6) were detected and treated with stent placement; lasting success (patency >12 months after retreatment) was achieved in 4. Early second and third recurrences arose in the other 2 stents within 3 months of the first retreatment; additional stents were placed at each recurrence. Both patients suffered a major cerebral event after 17 months. Less often, an "end of stent" stenosis (n = 3) developed at a kink in the ICA adjacent to the cephalad end of the stent. Lasting success was achieved by balloon dilation without additional stent placement in all 3 cases. No procedure-related complications were observed within 30 days after any treatment for restenosis.


CONCLUSIONS
Carotid stent restenosis, which occurs rarely after 1 year, can be treated safely by further percutaneous interventions.
Willfort-Ehringer
Andrea
A
Department of Medical Angiology, General Hospital of Vienna, University of Vienna Medical School, Währinger Gürtel 18-20, A-1090 Vienna, Austria. andrea.wilfort@akh-wien.ac.at
Ahmadi
Ramazanali
R
Gschwandtner
Michael E
ME
Haumer
Markus
M
Lang
Wilfried
W
Minar
Erich
E
D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D012008:Recurrence; D019233:Retreatment; D015607:Stents; D018615:Ultrasonography, Doppler, Color