title: Frequency and consequences of early in-stent lesions after carotid artery stent placement.
abstract: OBJECTIVE
  To examine the prevalence of in-stent lesions 1 month after carotid artery stent placement with multidetector computed tomography (CT) angiography and to evaluate their possible causes and their consequences during 1-year follow-up.
  
  
  METHODS
  Sixty-nine patients with symptomatic carotid artery stenosis underwent multidetector CT angiography of the carotid arteries 1 month after carotid artery stent placement. Patients were followed-up until 1 year after stent placement, when duplex ultrasonography (US) was performed. In-stent lesions were defined as hypo- or hyperattenuating lesions at the stent wall found with multidetector CT. Significant restenosis (70%) at 1 year was defined as a peak systolic velocity of more than 300 cm/sec at duplex US. The Fisher exact test was used to assess the relationship between early in-stent lesions and ischemic events and restenosis.
  
  
  RESULTS
  At 1 month, 14 of the 69 patients (20%) were found to have in-stent lesions. In one patient, the stent was occluded. The other 13 in-stent lesions did not result in significant lumen reduction. In the year following stent placement, no difference in ischemic events was found between patients with (14%) and those without (13%) early in-stent lesions (P = .99). There was no difference in the occurrence of restenosis at 1 year (7% vs 4%, P = .59).
  
  
  CONCLUSIONS
  At 1 month after carotid artery stent placement, in-stent lesions are found in about one-fifth of patients. These lesions do not appear to be related to recurrent ischemic events or to restenosis at 1 year.
authors.affiliation: Department of Radiology, University Medical Center Utrecht, Heidelberglaan, The Netherlands. L.Jongen@umcutrecht.nl
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Jongen
authors.forename: Jeroen
authors.initials: J
authors.lastname: Hendrikse
authors.forename: Annet
authors.initials: A
authors.lastname: Waaijer
authors.forename: H Bart
authors.initials: HB
authors.lastname: van der Worp
authors.forename: Vanessa J
authors.initials: VJ
authors.lastname: Leijdekkers
authors.forename: Rob T H
authors.initials: RT
authors.lastname: Lo
authors.forename: Willem P Th M
authors.initials: WP
authors.lastname: Mali
authors.forename: Mathias
authors.initials: M
authors.lastname: Prokop