title: Multicentric retrospective study of endovascular treatment for restenosis after open carotid surgery.
abstract: OBJECTIVE
  To analyse perioperative and midterm outcomes of carotid artery stenting (CAS) for symptomatic >50% and asymptomatic >70% restenosis after open carotid surgery (OCS).
  
  
  METHODS
  A multicentric retrospective study.
  
  
  METHODS
  Outcome measures 30-day death, neurologic and anatomic (thrombosis, restenosis) events. Univariant and multivariant logistic regression analyses were performed to identify predictive factors for neurologic and anatomic events.
  
  
  RESULTS
  A total of 249 patients with a mean age of 69 years (range, 45-88) were treated for asymptomatic (86%) or symptomatic (14%) restenosis. The 30-day combined operative mortality and stroke morbidity was 2.8% in asymptomatic patients and 2.9% in symptomatic patients. Events during follow-up (mean duration, 29 months) included stroke in four cases, TIA in two, stent thrombosis in four and restenosis in 21. Kaplan-Meier estimates of overall survival, neurologic-event-free survival, anatomic-event-free survival and reintervention-free survival were 95.4%, 94.7%, 96.7% and 99.5%, respectively, at 1 year and 80.3%, 93.8%, 85.1% and 96%, respectively, at 4 years. Multivariant analysis showed that statin use was correlated with a lower risk of anatomic events (odds ratio (OR) = 0.15 (95% confidence interval (CI) 0.03-0.68), p = 0.01) and that bypass was associated with a higher risk of anatomic events than endarterectomy (OR = 5.0 (95% CI 1.6-16.6), p = 0.009).
  
  
  CONCLUSIONS
  CAS is a feasible therapeutic alternative to OCS for carotid restenosis with acceptable risks in the perioperative period. Restenosis rate may be higher in patients treated after bypass.
authors: Vascular Surgery Department, Bordeaux University Hospital, France. dominique.midy@chu-bordeaux.fr
authors: D
authors: D
authors: Midy
authors: X
authors: X
authors: Berard
authors: J P
authors: JP
authors: Becquemin
authors: P
authors: P
authors: Patra
authors: P
authors: P
authors: Alric
authors: P
authors: P
authors: Derrider
authors: P E
authors: PE
authors: Magnan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium; D002343:Carotid Artery, Internal / Q000601:surgery; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D002533:Cerebral Angiography; D001026:Coronary Artery Bypass; D018572:Disease-Free Survival; D016894:Endarterectomy, Carotid; D005240:Feasibility Studies; D005260:Female; D005602:France; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009460:Neurologic Examination; D016017:Odds Ratio; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D055502:Secondary Prevention; D013223:Statistics as Topic; D015607:Stents; D014057:Tomography, X-Ray Computed
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors