[Angiographic follow-up after carotid artery stenting of bifurcation stenosis].
OBJECTIVE
The purpose of this prospective study was to determine the restenosis grade, the intima hyperplasia and the stent expansion via angiographic follow-up six months after carotid artery stenting.


METHODS
In 100 patients, angiographic follow-up was performed 5.9 months (range: 2.9-11.4 months) after carotid artery stenting. The restenosis grade, the intima hyperplasia and the stent expansion were measured by selective angiography of the treated carotid artery.


RESULTS
The mean restenosis grade was 16 % (range: 0-78 %). In 6 of 100 patients (6 %), a restenosis grade of > 50 % was measured. In 4 patients the restenosis grade was 50-70 %. In 2 patients the restenosis grade was > 70 %. In 91 of 100 patients (91 %), the restenosis was localized in the former area of stenosis of the carotid artery, and in 9 of 100 patients (9 %), the restenosis was localized in the cranial stent end. The mean grade of intima hyperplasia was 31 % (range: 2-70 %). The mean increase in stent expansion at the time of follow-up was 10 % (range: 0-59 %). No correlation was able to be determined between the grade of stenosis and the grade of restenosis (rho = 0.017, range: - 0.180-0.213), between the grade of residual stenosis and the grade of restenosis (rho = 0.257, range: 0.064-0.431) and between intima hyperplasia and the grade of restenosis (rho = 0.476, range: 0.309-0.615).


CONCLUSIONS
Carotid artery stenting is associated with a low incidence of high-grade restenosis 6 months after an intervention. The intima hyperplasia, which can be observed in each Wallstent, is partly compensated by the expansion of the self-expandable stent. Without a correlation between the grade of residual stenosis and the grade of restenosis, low-grade residual stenosis can be accepted. Therefore, we recommend undersized postdilation of the Wallstent.
Hauth
E A
EA
Institut für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinik Essen. elke.hauth@uni-essen.de
Jansen
C
C
Drescher
R
R
Schwarz
M
M
Christmann
A
A
Jaeger
H
H
Forsting
M
M
Mathias
K
K
D000368:Aged; D000792:Angiography / Q000706:statistics & numerical data; D001807:Blood Vessel Prosthesis / Q000706:statistics & numerical data*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D008297:Male; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015607:Stents / Q000706:statistics & numerical data*; D016896:Treatment Outcome