Carotid angioplasty and stenting versus redo endarterectomy for recurrent stenosis.
BACKGROUND
Carotid angioplasty and stent (CAS) is an alternative to redo carotid endarterectomy (RCEA) for recurrent carotid stenosis (RCS). The purpose of this study was to evaluate the outcomes of CAS in the treatment of RCS.


METHODS
In an 8-year period, all patients presenting for treatment of RCS were followed-up prospectively. Logistic regression analysis was performed to identify variables associated with unfavorable outcomes.


RESULTS
There were 45 CAS and 46 RCEA procedures performed in 75 patients. One patient in each group suffered a stroke. There were no deaths. The hospital length of stay was significantly shorter for CAS. Secondary recurrence was higher after RCEA (14% vs 6.1%) and failure to take beta-blockers was an independent predictor for multiple recurrences.


CONCLUSIONS
CAS is a safe and effective method to treat patients with RCS and may become the procedure of choice for this disease.
Bettendorf
Matthew J
MJ
Grand Rapids Michigan State University General Surgery Program, Grand Rapids Medical Education and Research Center, Grand Rapids, MI, USA.
Mansour
M Ashraf
MA
Davis
Alan T
AT
Sugiyama
George T
GT
Cali
Robert F
RF
Gorsuch
Jill M
JM
Cuff
Robert F
RF
D000368:Aged; D017130:Angioplasty / Q000379:methods*; D016893:Carotid Stenosis / Q000601:surgery*; D016894:Endarterectomy, Carotid / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012008:Recurrence; D012086:Reoperation / Q000379:methods; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome